Rui Guo1, Han Wu2, Jun Wang3, Chen-Lu Lian3, Zhen-Yu He1, Wen-Wen Zhang1, Yong-Xiong Chen4, San-Gang Wu5. 1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China. 2. Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Medical College, Xiamen University, Xiamen, People's Republic of China. 3. Department of Radiation Oncology, Cancer Hospital, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, People's Republic of China. 4. Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Medical College, Xiamen University, Xiamen, People's Republic of China. yxchen1962@xmu.edu.cn. 5. Department of Radiation Oncology, Cancer Hospital, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, People's Republic of China. wusg@xmu.edu.cn.
Abstract
INTRODUCTION: We aimed to investigate the clinical effect of histological subtypes on survival in nasopharyngeal carcinoma (NPC), and assess the effect of nodal stage on outcome according to histological subtypes. METHODS: Patients with non-metastatic NPC were identified from the Surveillance, Epidemiology and End-Results (SEER) database between 2004 and 2014. Statistical analysis was performed using the chi-squared test, Kaplan-Meier methods, and multivariate Cox regression models. RESULTS: We identified 2845 patients in this study including 1218 (42.8%), 849 (29.8%), and 778 (27.3%) patients with keratinizing squamous cell carcinoma (KSCC), differentiated non-keratinizing squamous cell carcinoma (DNKSCC), and undifferentiated non-keratinizing squamous cell carcinoma (UNKSCC), respectively. The multivariate analysis indicated that patients with UNKSCC subtype had better NPC-specific survival (NPC-SS) (P < 0.001) compared to KSCC (P < 0.001) and DNKSCC (P < 0.001) patients. The 5-year NPC-SS was 75.2%, 77.9%, and 88.9% in patients with KSCC, DNKSCC, UNKSCC, respectively (P < 0.001). Subgroup analysis showed that advanced nodal stage was related to lower NPC-SS in patients with DNKSCC and UNKSCC but not in patients with KSCC. CONCLUSIONS: Histology is an independent prognostic factor in patients with NPC. However, advanced nodal stage is not associated with lower survival in KSCC.
INTRODUCTION: We aimed to investigate the clinical effect of histological subtypes on survival in nasopharyngeal carcinoma (NPC), and assess the effect of nodal stage on outcome according to histological subtypes. METHODS:Patients with non-metastatic NPC were identified from the Surveillance, Epidemiology and End-Results (SEER) database between 2004 and 2014. Statistical analysis was performed using the chi-squared test, Kaplan-Meier methods, and multivariate Cox regression models. RESULTS: We identified 2845 patients in this study including 1218 (42.8%), 849 (29.8%), and 778 (27.3%) patients with keratinizing squamous cell carcinoma (KSCC), differentiated non-keratinizing squamous cell carcinoma (DNKSCC), and undifferentiated non-keratinizing squamous cell carcinoma (UNKSCC), respectively. The multivariate analysis indicated that patients with UNKSCC subtype had better NPC-specific survival (NPC-SS) (P < 0.001) compared to KSCC (P < 0.001) and DNKSCC (P < 0.001) patients. The 5-year NPC-SS was 75.2%, 77.9%, and 88.9% in patients with KSCC, DNKSCC, UNKSCC, respectively (P < 0.001). Subgroup analysis showed that advanced nodal stage was related to lower NPC-SS in patients with DNKSCC and UNKSCC but not in patients with KSCC. CONCLUSIONS: Histology is an independent prognostic factor in patients with NPC. However, advanced nodal stage is not associated with lower survival in KSCC.