Clinicopathological features and prognosis of nasopharyngeal adenocarcinoma / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinical manifestations, EB virus serology and treatment outcome of nasopharyngeal adenocarcinoma (NPAC).</p><p><b>METHODS</b>Clinical records of NPAC patients between 1964 and 2000 in Cancer Center of Sun Yat-sen University were retrospectively reviewed.</p><p><b>RESULTS</b>Among 48 patients with NPAC, 45.2% (7 cases of N1, 8 cases of N2 and 4 cases of N3) of them presented with cervical metastasis. Pathologically, common type and salivary gland type of NPAC accounted for 58.3% (28 cases) and 41.7% (20 cases) respectively. The positive rate of the EB virus antibody VCA-IgA was 56.7% in the whole group and only 23.7% in the salivary gland type of NPAC. The overall local control rate and the 5-year disease free survival rate by Kaplan-Meier method were 87.0% (40/46) and 65.2% respectively. Baseline data analysis showed that age, gender, N stage and M stage were not the significant factors, never the less the T stage was not balanced between the two groups (surgery plus radiotherapy vs radiotherapy alone, chi2 = 4.801, P = 0.045). The patients treated by surgery plus radiotherapy had significantly higher 5-year disease free survival rate than by radiotherapy alone (88.9% vs 74.7%, Log Rank test chi2 = 4.272, P = 0.039). Cox's multivariate analysis showed treatment modality and N stage were the significant factors influencing survival (RR were 15.276 and 6.529, P < 0.05).</p><p><b>CONCLUSIONS</b>NPAC is a distinct entity in all types of nasopharyngeal carcinoma. EB virus serology has limited value in its diagnosis. Surgery plus radiotherapy could be another choice of treatment for early lesions of NPAC.</p>