Jeremy Chee1, Kwok Seng Loh1, Ivan Tham2, Francis Ho2, Lea Choung Wong2, Chee Seng Tan3, Boon Cher Goh3, Chwee Ming Lim4. 1. Department of Otolaryngology-Head and Neck Surgery, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore, 119228, Singapore. 2. Department of Radiation Oncology, National University Health System, Singapore, Singapore. 3. Department of Medical Oncology, National University Health System, Singapore, Singapore. 4. Department of Otolaryngology-Head and Neck Surgery, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore, 119228, Singapore. chwee_ming_lim@nuhs.edu.sg.
Abstract
PURPOSE: Metastatic nasopharyngeal cancer (NPC) is known to have poor survival outcomes. Clinical and biochemical parameters may impact survival outcomes among patients with metastatic NPC and may be used for prognostication. METHODS: One-hundred and fifty-eight patients with metastatic NPC treated at a single tertiary institution were analyzed retrospectively. Multivariate analysis was carried out on patients who were given disease control treatment (n = 135). A numerical score derived from the regression coefficients of each identified independent variable was used to create prognostic groups (PG). A p value of less than 0.05 was considered significant. RESULTS: Independent negative prognostic factors included ECOG status >1, LDH level >580 U/L, hemoglobin level <12.0 g/dL and having more than one metastatic organ involvement. Three PGs were obtained: low risk (total score = 0), intermediate risk (1-2) and high risk (3-4). Median survivals of the 3 groups (low, intermediate and high risk) were 57.1, 18.1 and 8.0 months for the three different risk groups, respectively (p < 0.001). CONCLUSION: Risk stratification of patients with metastatic nasopharyngeal cancer is possible using a prognostic scoring system based on clinical and biochemical parameters. Patients with low-risk score may achieve good metastatic survival and may benefit from additional therapy for disease control.
PURPOSE:Metastatic nasopharyngeal cancer (NPC) is known to have poor survival outcomes. Clinical and biochemical parameters may impact survival outcomes among patients with metastatic NPC and may be used for prognostication. METHODS: One-hundred and fifty-eight patients with metastatic NPC treated at a single tertiary institution were analyzed retrospectively. Multivariate analysis was carried out on patients who were given disease control treatment (n = 135). A numerical score derived from the regression coefficients of each identified independent variable was used to create prognostic groups (PG). A p value of less than 0.05 was considered significant. RESULTS: Independent negative prognostic factors included ECOG status >1, LDH level >580 U/L, hemoglobin level <12.0 g/dL and having more than one metastatic organ involvement. Three PGs were obtained: low risk (total score = 0), intermediate risk (1-2) and high risk (3-4). Median survivals of the 3 groups (low, intermediate and high risk) were 57.1, 18.1 and 8.0 months for the three different risk groups, respectively (p < 0.001). CONCLUSION: Risk stratification of patients with metastatic nasopharyngeal cancer is possible using a prognostic scoring system based on clinical and biochemical parameters. Patients with low-risk score may achieve good metastatic survival and may benefit from additional therapy for disease control.
Authors: Samuel Jun Ming Lim; Narayanan Gopalakrishna Iyer; London Lucien Ooi; Heng Nung Koong; Alexander Yaw Fui Chung; Hiang Khoon Tan; Khee Chee Soo; Ngian Chye Tan Journal: Head Neck Date: 2015-07-15 Impact factor: 3.147
Authors: Jeremy Chee; Yohanes Ting; Yew Kwang Ong; Siew Shuen Chao; Kwok Seng Loh; Chwee Ming Lim Journal: Head Neck Date: 2016-04-04 Impact factor: 3.147
Authors: Raymond W Jang; Valerie B Caraiscos; Nadia Swami; Subrata Banerjee; Ernie Mak; Ebru Kaya; Gary Rodin; John Bryson; Julia Z Ridley; Lisa W Le; Camilla Zimmermann Journal: J Oncol Pract Date: 2014-08-12 Impact factor: 3.840
Authors: L Benboubker; C Valat; C Linassier; G Cartron; M Delain; M Bout; F Fetissof; T Lefranq; J P Lamagnere; P Colombat Journal: Ann Oncol Date: 2000-11 Impact factor: 32.976
Authors: Gunnar Birgegård; Matti S Aapro; Carsten Bokemeyer; Mario Dicato; Peter Drings; Javier Hornedo; Maciej Krzakowski; Heinz Ludwig; Sergio Pecorelli; Hans Schmoll; Maurice Schneider; Dirk Schrijvers; Daniel Shasha; Simon Van Belle Journal: Oncology Date: 2005 Impact factor: 2.935