BACKGROUND: Distant metastases are common in patients with nasopharyngeal carcinoma (NPC), and their presence is the most important factor in limiting survival. We aimed to study the prognosticators determining survival subsequent to distant metastasis from NPC. METHODS: A study by both mono- and multivariate analyses was carried out in 945 patients presenting between 1984 and 1989. Forty-two presented with metastases and 247 developed metastasis after primary radiotherapy. RESULTS: Patients who presented with distant metastasis (M1-classification) had a significantly shorter survival than those who developed metastases after primary radiotherapy. The presence of hepatic metastases, short metastasis free interval, and older age at presentation significantly predicted short survival after the diagnosis of distant metastasis. Patients with metastases preceded by, and/or accompanied with, locoregional recurrence had comparable survival to those without, despite their association with a significantly longer metastasis free interval. A history of locoregional recurrence was however not compatible with long term, disease free survival, and, in its presence, advanced T-classification on presentation predicted poor survival subsequent to metastasis. Long term disease free survival (64-117 months) was attained in 4 young patients (age < 40 years) with isolated intrathoracic metastases in the absence of locoregional recurrence after achieving a complete response to aggressive treatment, with chemotherapy, radiotherapy, and/or surgery, usually multimodal. CONCLUSIONS: Some of the clinical prognosticators have been identified and an attempt was made to subclassify distant metastases according to possible differences in prognosis. A subset of metastatic NPC was identified which is compatible with long term, disease free survival. Investigations during follow-up should be directed toward the early detection of such potentially salvageable cases.
BACKGROUND: Distant metastases are common in patients with nasopharyngeal carcinoma (NPC), and their presence is the most important factor in limiting survival. We aimed to study the prognosticators determining survival subsequent to distant metastasis from NPC. METHODS: A study by both mono- and multivariate analyses was carried out in 945 patients presenting between 1984 and 1989. Forty-two presented with metastases and 247 developed metastasis after primary radiotherapy. RESULTS:Patients who presented with distant metastasis (M1-classification) had a significantly shorter survival than those who developed metastases after primary radiotherapy. The presence of hepatic metastases, short metastasis free interval, and older age at presentation significantly predicted short survival after the diagnosis of distant metastasis. Patients with metastases preceded by, and/or accompanied with, locoregional recurrence had comparable survival to those without, despite their association with a significantly longer metastasis free interval. A history of locoregional recurrence was however not compatible with long term, disease free survival, and, in its presence, advanced T-classification on presentation predicted poor survival subsequent to metastasis. Long term disease free survival (64-117 months) was attained in 4 young patients (age < 40 years) with isolated intrathoracic metastases in the absence of locoregional recurrence after achieving a complete response to aggressive treatment, with chemotherapy, radiotherapy, and/or surgery, usually multimodal. CONCLUSIONS: Some of the clinical prognosticators have been identified and an attempt was made to subclassify distant metastases according to possible differences in prognosis. A subset of metastatic NPC was identified which is compatible with long term, disease free survival. Investigations during follow-up should be directed toward the early detection of such potentially salvageable cases.
Authors: Vivian Wai Yan Lui; Cecilia Pik Yuk Lau; Kakiu Ho; Margaret Heung Ling Ng; Suk Hang Cheng; Sai-Wah Tsao; Chi Man Tsang; Kenny Ieng Kit Lei; Anthony Tc Chan; Tony Shu Kam Mok Journal: Invest New Drugs Date: 2010-06-23 Impact factor: 3.850
Authors: Jeremy Chee; Kwok Seng Loh; Ivan Tham; Francis Ho; Lea Choung Wong; Chee Seng Tan; Boon Cher Goh; Chwee Ming Lim Journal: J Cancer Res Clin Oncol Date: 2017-08-28 Impact factor: 4.553