Abstract
Purpose
Metastatic nasopharyngeal cancer (NPC) is known to have poor survival outcomes. Clinical and biochemical parameters may impact survival outcomes among patients with metastatic NPC and may be used for prognostication.
Methods
One-hundred and fifty-eight patients with metastatic NPC treated at a single tertiary institution were analyzed retrospectively. Multivariate analysis was carried out on patients who were given disease control treatment (n = 135). A numerical score derived from the regression coefficients of each identified independent variable was used to create prognostic groups (PG). A p value of less than 0.05 was considered significant.
Results
Independent negative prognostic factors included ECOG status >1, LDH level >580 U/L, hemoglobin level <12.0 g/dL and having more than one metastatic organ involvement. Three PGs were obtained: low risk (total score = 0), intermediate risk (1–2) and high risk (3–4). Median survivals of the 3 groups (low, intermediate and high risk) were 57.1, 18.1 and 8.0 months for the three different risk groups, respectively (p < 0.001).
Conclusion
Risk stratification of patients with metastatic nasopharyngeal cancer is possible using a prognostic scoring system based on clinical and biochemical parameters. Patients with low-risk score may achieve good metastatic survival and may benefit from additional therapy for disease control.
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Acknowledgements
Dr. Lim Chwee Ming acknowledges the Transitional Award for research support by the National Medical Research Council Singapore for this study. The authors would also like to thank Dr. Shen Liang from the Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, for her help with statistical analysis.
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Chee, J., Loh, K.S., Tham, I. et al. Prognostic stratification of patients with metastatic nasopharyngeal carcinoma using a clinical and biochemical scoring system. J Cancer Res Clin Oncol 143, 2563–2570 (2017). https://doi.org/10.1007/s00432-017-2496-1
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DOI: https://doi.org/10.1007/s00432-017-2496-1