ABSTRACT
Objective To evaluate the prognostic value of the extracapsular spread (ECS) of regional lymph nodes in nasopharyngeal carcinoma (NPC) based on magnetic resonance imaging.Methods A retrospective review was performed for 477 previously untreated patients with NPC who were treated in Yuebei People′s Hospital from January 2009 to December 2013.Univariate and multivariate survival analyses were performed to identify the prognostic value of ECS in NPC.Results There were 216 patients with ECS and 261 patients without ECS,and the median survival of the two groups of patients was 38.5 months and 39.0 months,respectively.The 3-year overall survival (OS),progression-free survival (PFS),local recurrence-free survival (LRFS),and distant metastasis-free survival (DMFS) rates of the patients with ECS versus those without ECS were 81.9% versus 90.7%,65.8% versus 85.0%,87.8% versus 95.8%,and 80.3% versus 92.9%,respectively (all P=0.000).The univariate analysis showed that N stage and ECS were important prognostic factors for OS,PFS,LRFS,and DMFS in NPC patients (P=0.000-0.004),and T stage and TNM stage were associated with OS,PFS,and DMFS (all P=0.000).The multivariate analysis using the Cox regression model showed that T stage was an independent prognostic factor for the survival of NPC patients,and ECS was an important prognostic factor for PFS,LRFS,and DMFS.Conclusion ECS of regional lymph nodes is a risk factor for local recurrence or distant metastasis in patients with NPC.
ABSTRACT
Objective:To explore the effect of family history of cancer on clinical features and prognostic factors in nasopharyngeal car-cinoma (NPC) patients. Methods:The clinical data of 89 NPC patients with a family history of cancer and 388 NPC patients without a family history of cancer were retrospectively reviewed. Univariate and multivariate survival analyses were performed to identify possi-ble prognostic factors. Results:The clinical characteristics of NPC patients with and without family history of cancer were compared. The gender, age, TNM stage, pathological type, and hemoglobin radiotherapy concentration before treatment did not significantly dif-fer between the two groups (P>0.05). NPC patients with a family history of cancer had better 3-year overall survival than those with-out family history of cancer (91.6%vs. 85.5%), but no statistically significant difference was observed (P=0.211). Both univariate and multivariate analyses showed that T, N, and TNM stages were the important prognosis factors affecting 3-year overall survival (OS), progression free survival (PFS), and distant metastasis-free survival (DMFS) of NPC (P0.05). Conclusion:NPC patients with family history of cancer had better 3-year OS than those without family history of cancer, but no statistically significant observation was found. Large T stage or high lymph node stage contributed to poor survival of NPC. Family history of cancer had no significant in-fluence on the survival of NPC patients.