Yixin Fan1,2, Wenqiang Guan1,2, Rui Huang1, Stefan Yujie Lin3,4, Yanqiong Song1, Shun Lu1, Le Kang1,2, Qin Yang1,2, Jinyi Lang1, Peng Zhang1. 1. Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China. 2. Graduate School, Chengdu Medical College, Chengdu, China. 3. Department of Computer Science and Engineering, Office for Student Affairs, University of Minnesota-Twin Cities, Economics Institute, School of Statistics, Minneapolis, MN, USA. 4. Viterbi School of Engineering Applied Data Science, University of Southern California, Los Angeles, CA, USA.
Abstract
PURPOSE: To compare the clinical characteristics and survival outcomes of patients with ascending type (type A), descending type (type D), and mixed type (type AD) of nasopharyngeal carcinoma (NPC) in non-endemic areas. MATERIALS AND METHODS: The cohort included 628 patients diagnosed with type A, type D, and type AD of NPC between January 2009 and December 2014. Type A was defined as T3-4 N0-1 , type D as T0-1 N2-3 , and type AD as T3-4 N2-3 . Propensity score matching (PSM) was performed to balance clinical factors and match patients. Kaplan-Meier methods and Cox proportional hazards models were used to evaluate the impact of different NPC types on survival outcomes. RESULTS: There were 145 patients with type A, 194 with type D, and 289 with type AD. However, after PSM, there were only 130 patients with each type. Compared with patients with type A, those with type D had lower 5-year disease-specific survival (96.9% vs 91.5%) and distant metastasis-free survival (92.3% vs 77.7%) and higher local relapse-free survival (88.5% vs 96.9%) (p < 0.05 for all). Patients with type AD may have an increased risk of disease progression (progression-free survival, 56.9% vs 74.6% and 66.2%) and death (overall survival [OS], 76.9% vs 85.4% and 85.4%) (p < 0.05 for all) compared to patients with the other two types of tumors. We further analyzed the metastasis trend. Similar metastasis patterns were observed in types AD and D, and types AD and A had similar recurrence trends. The mortality rate of patients with types AD and D in the first 3 years after metastasis was remarkably higher than that of patients with type A. CONCLUSIONS: In non-endemic areas of China, metastases and recurrence patterns differed across tumor types. Type AD has the worst OS, and the clinical process is more radical. Type D has a lower recurrence rate, higher metastasis, and disease-related mortality rates, and poorer prognosis after metastasis than type A.
PURPOSE: To compare the clinical characteristics and survival outcomes of patients with ascending type (type A), descending type (type D), and mixed type (type AD) of nasopharyngeal carcinoma (NPC) in non-endemic areas. MATERIALS AND METHODS: The cohort included 628 patients diagnosed with type A, type D, and type AD of NPC between January 2009 and December 2014. Type A was defined as T3-4 N0-1 , type D as T0-1 N2-3 , and type AD as T3-4 N2-3 . Propensity score matching (PSM) was performed to balance clinical factors and match patients. Kaplan-Meier methods and Cox proportional hazards models were used to evaluate the impact of different NPC types on survival outcomes. RESULTS: There were 145 patients with type A, 194 with type D, and 289 with type AD. However, after PSM, there were only 130 patients with each type. Compared with patients with type A, those with type D had lower 5-year disease-specific survival (96.9% vs 91.5%) and distant metastasis-free survival (92.3% vs 77.7%) and higher local relapse-free survival (88.5% vs 96.9%) (p < 0.05 for all). Patients with type AD may have an increased risk of disease progression (progression-free survival, 56.9% vs 74.6% and 66.2%) and death (overall survival [OS], 76.9% vs 85.4% and 85.4%) (p < 0.05 for all) compared to patients with the other two types of tumors. We further analyzed the metastasis trend. Similar metastasis patterns were observed in types AD and D, and types AD and A had similar recurrence trends. The mortality rate of patients with types AD and D in the first 3 years after metastasis was remarkably higher than that of patients with type A. CONCLUSIONS: In non-endemic areas of China, metastases and recurrence patterns differed across tumor types. Type AD has the worst OS, and the clinical process is more radical. Type D has a lower recurrence rate, higher metastasis, and disease-related mortality rates, and poorer prognosis after metastasis than type A.
Authors: Yiat Horng Leong; Yu Yang Soon; Khai Mun Lee; Lea Choung Wong; Ivan Weng Keong Tham; Francis Cho Hao Ho Journal: Head Neck Date: 2017-11-11 Impact factor: 3.147
Authors: Chiun Hsu; Se-Hoon Lee; Samuel Ejadi; Caroline Even; Roger B Cohen; Christophe Le Tourneau; Janice M Mehnert; Alain Algazi; Emilie M J van Brummelen; Sanatan Saraf; Pradeep Thanigaimani; Jonathan D Cheng; Aaron R Hansen Journal: J Clin Oncol Date: 2017-08-24 Impact factor: 44.544
Authors: C Zhao; J Miao; G Shen; J Li; M Shi; N Zhang; G Hu; X Chen; X Hu; S Wu; J Chen; X Shao; L Wang; F Han; H Mai; M L K Chua; C Xie Journal: Ann Oncol Date: 2019-04-01 Impact factor: 32.976
Authors: Freddie Bray; Jacques Ferlay; Isabelle Soerjomataram; Rebecca L Siegel; Lindsey A Torre; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2018-09-12 Impact factor: 508.702