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Prognostic models for 1-year survival of NPC after radiotherapy in different ages

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Abstract

Purpose

Previous studies have shown that approximately 10% of nasopharyngeal cancer (NPC) patients die within a year of disease onset, and that age is an independent predictor. However, no predictive model has been developed. We aimed to establish novel prognostic models to predict the 1-year cancer-specific survival (CSS) of young, middle-aged, and older patients with NPC after radiotherapy.

Methods

The data of 2822 NPC patients who underwent radiotherapy between 2004 and 2015 were reviewed from the surveillance, epidemiology, and end results database. We divided them into young, middle-aged, and older people groups according to age (< 44 years, 45–59 years, and ≥ 60 years, respectively). Multivariate analyses were performed, and prognostic models were constructed.

Results

Multivariate analyses indicated that age, ethnicity, histological subtype, T, and M stage were independent predictors of 1-year CSS in the older people group. In contrast, ethnicity and age were not found to have predictive value in the young and middle-aged groups, respectively. Accordingly, three prognostic models with excellent predictive values were established for the three groups (C-indices: 0.791 [95% CI 0.722–0.859], 0.763 [95% CI 0.721–0.806] and 0.723 [95% CI 0.683–0.763], respectively). These predictive values are higher than those of the eighth edition American joint committee cancer tumor-node-metastasis (TNM) classification system.

Conclusion

Three prognostic models for predicting the 1-year CSS of young, middle-aged, and older NPC patients after radiotherapy showed better predictive power than the TNM classification system. These models may guide treatment strategies and clinical decision-making in different cohorts.

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Acknowledgements

The authors would like to thank all the medical staff who contributed to the maintenance of the medical record database.

Funding

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Author notes

  1. Qu-xia Zhang and Lv-ping Zhuang have contributed equally to this work.

Authors and Affiliations

  1. Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fu-ma Road, Fuzhou, 350014, China

    Qu-xia Zhang

  2. Fujian Medical University, Fuzhou, China

    Lv-ping Zhuang

  3. Department of Otolaryngology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China

    Zhong-yang Lin

Authors
  1. Qu-xia Zhang
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  2. Lv-ping Zhuang
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Contributions

QZ: conceived the study, analyzed the data, and drafted the manuscript. LZ: analyzed the data, and drafted the manuscript. ZL: helped critically revise the manuscript for important intellectual content.

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Correspondence to Qu-xia Zhang.

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The authors have no financial relationships or conflicts of interest to disclose.

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Zhang, Qx., Zhuang, Lp. & Lin, Zy. Prognostic models for 1-year survival of NPC after radiotherapy in different ages. Eur Arch Otorhinolaryngol 278, 4955–4965 (2021). https://doi.org/10.1007/s00405-021-06730-8

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  • DOI: https://doi.org/10.1007/s00405-021-06730-8

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