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Lifestyle, Epstein-Barr virus infection, and other factors could impede nasopharyngeal cancer survivorship: a five-year cross-sectional study in North Eastern India

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Abstract

Nasopharyngeal Carcinoma (NPC) is one of the leading cancers in India’s north-eastern (NE) region affecting a section of the population each year. A proportion of the NPC cases are observed to recur even after therapy, indicating the involvement of other factors. We aimed to explore the NPC and Epstein-Barr virus (EBV) burden in the NE region and investigate the prognostic factors for the NPC patients’ poor survival and recurrence. NPC patients’ information was obtained from different state hospitals between 2014 and 2019. PCR and Sanger sequencing were performed to detect EBV types. Statistical analysis, including forest plot analysis, Kaplan-Mayer survival plot, Log-rank test, cox hazard regression, and Aalen’s additive regression model, were performed to determine prognostic factors for the NPC patients’ lower survival and recurrence. We observed an increased incidence of NPC and EBV infection in the past five years. Step-wise statistical analyses pointed out that variable such as non-professionals (B = 1.02, HR = 2.8, 95%CI = 1.5,4.9) workers (B = 0.92, HR = 2.5, 95%CI = 1.4,4.4), kitchen cum bedroom (B = 0.61, HR = 1.8, 95%CI = 1.2,2.8), mosquito repellent (B = 0.60, HR = 1.7, 95%CI = 1.1,2.7), nasal congestion (B = 0.60, HR = 1.8, 95%CI = 1.2,2.8), lower haemoglobin level (B = 0.92, HR = 2.5, 95%CI = 1.3,4.9), tumor stage IV (B = 2.8, HR = 1.8, 95%CI = 1.6,14.3), N2 (B = 1.4, HR = 4.0, 95%CI = 1.8,9.1), N3 (B = 1.9, HR = 6.4, 95%CI = 2.8,15.3), and M+ (B = 2.02, HR = 7.5, 95%CI = 4.1,13.7) revealed significant correlation with NPC patients’ poor prognosis (p < 0.05). The presence of viral factors also showed a significant association with NPC patients’ decreased survival. We concluded that factors related to day-to-day life with EBV infection could be the individual predictor for NPC incidence, lower survival, and disease recurrence.

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Acknowledgements

This work was supported by Visva-Bharati University, West Bengal, India. We express sincere gratitude to the doctors and workers of Eden Hospital Dimapur, Nagaland, Dr. Bhubaneswar Borooah Cancer Institute, Guwahati, Assam; Cachar Cancer Hospital & Research Center, Silchar, Assam; Guwahati Medical College & Hospital, Guwahati, Assam; Civil Hospital, Aizawl, Mizoram and Regional Institute of Medical Sciences, Imphal. No funding was received for this project.

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Authors and Affiliations

  1. Department of Biotechnology, Visva-Bharati, Santiniketan, Birbhum, West Bengal, India

    Koustav Chatterjee, Koushik Chakraborty, Asmaul Haque, Syamantak Mukherjee, Sudipa Mal, Nilanjana Das, Nabanita Roy Chattopadhyay, Piyanki Das & Tathagata Choudhuri

  2. Department of Radiation Oncology, Eden Medical Center, Dimapur, Nagaland, India

    Sankar Deb Roy

  3. Midnapore City College, Paschim Medinipur, Kuturia, Bhadutala, West Bengal, India

    Sudipta Chakrabarti

  4. Department of zoology, Visva-Bharati, Santiniketan, West Bengal, India

    Sushil Kumar Sahu

  5. Clinical Proteomics, Institute of Life Sciences, Bhubaneswar, India

    R. Rajendra Reddy, Bhabani Sankar Das & Amol Ratnakar Suryawanshi

  6. Department of pathology, Eden Medical Center, Dimapur, Nagaland, India

    Moatoshi Aier

  7. Department of Head & Neck Oncology, Dr. Bhubaneswar Borooah Cancer Institute, Guwahati, Assam, India

    Ashok Kumar Das & Nizara Baishya

  8. Cachar Cancer Hospital and Research Centre. N. S. Avenue, Meherpur, Silchar, Assam, India

    R Ravi Kannan

  9. State Referral Hospital, Falkawn, Mizoram, India

    Zoreng puii & Eric Zomawia

  10. Department of Radiotherapy, Regional Institute of Medical Sciences, Imphal, Manipur, India

    Yengkhom Indibor Singh

  11. Tertiary cancer center, TomoRiba Institute Of Health, and Medical Sciences, Naharlagun, Arunachal Pradesh, India

    Sam Tsering & Komri Riba

  12. Division of Genetic Disorders, ICMR-National Institute of Research in Tribal Health, NIRTH Complex, Jabalpur, Madhya Pradesh, India

    Shanmugam Rajasubramaniam

  13. Department of Statistics, Visva-Bharati, Santiniketan, West Bengal, India

    Arindom Chakraborty

  14. Division of Animal and Fishery Science, ICAR Research Complex for North East Hill Region, Umiam, Meghalaya, India

    Sandeep Ghatak

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  1. Koustav Chatterjee
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Contributions

Koustav Chatterjee: Conceptualization, Study design, Data Collection, analysis, literature search, data interpretation, figure and manuscript writing; Koushik Chakraborty, Asmaul Haque and Syamantak Mukherjee: Helped on Statistical analysis, literature search and figure drawing; Sudipta Chakrabarti and Sushil Kumar Sahu: Helped on study design; Sankar Deb Roy, Moatoshi Aier, Ashok Kumar Das, Nizara Baishya, R Ravi Kannan, Zoreng puii, Eric Zomawia, Y Indibar Singh, Sam Tserin, and Komri Riba: provided the NPC samples, patient’s information and helped on data collection; Nabanita Roy Chattopadhyay, Piyanki Das, Sudipa Mal, Nilanjana Das: assisted on literature search and data interpretation; Amol Suryawanshi and R Rajendra Reddy: Assisted on compiling the parent’s report; Arindom Chakraborty: Assisted on the statistical analysis; Bhabani Sankar Das, Sandeep Ghatak and Shanmugam Rajasubramaniamn: Helped on the data interpretation and manuscript writing; Tathagata Choudhuri: Supervised the work, assisted on the data interpretation and reviewed the manuscript.

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Correspondence to Tathagata Choudhuri.

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Chatterjee, K., Roy, S.D., Chakraborty, K. et al. Lifestyle, Epstein-Barr virus infection, and other factors could impede nasopharyngeal cancer survivorship: a five-year cross-sectional study in North Eastern India. VirusDis. 33, 371–382 (2022). https://doi.org/10.1007/s13337-022-00789-5

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