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Establishment and Validation of a Nomogram for Nasopharyngeal Carcinoma Patients Concerning the Prognostic Effect of Parotid Lymph Node Metastases
Chao Lin, Xue-Song Sun, Sai-Lan Liu, Xiao-Yun Li, Nian Lu, Xin-Ling Li, Lin-Quan Tang, Ling Guo
Cancer Res Treat. 2020;52(3):855-866.   Published online March 10, 2020
DOI: https://doi.org/10.4143/crt.2019.772
AbstractAbstract PDFPubReaderePub
Purpose
The prognosis of nasopharyngeal carcinoma (NPC) patients with parotid lymph node (PLN) metastasis remains unclear. This study was performed to investigate the prognostic significance and optimal staging category of PLN metastasis and develop a nomogram for estimating individual risk.
Materials and Methods
Clinical data of 7,084 non-metastatic NPC patients were retrospectively reviewed. Overall survival (OS) was the primary endpoint. A nomogram was established based on the Cox proportional hazards regression model. The accuracy and calibration ability of this nomogram was evaluated by C-index and calibration curves with bootstrap validation.
Result
Totally, 164/7,084 NPC patients (2.3%) presented with PLNs. Multivariate analyses showed that PLN metastasis was a negative prognostic factor for OS, progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS). Patients with PLN metastasis had a worse prognosis than N3 disease. Five independent prognostic factors were included in the nomogram, which showed a C-index of 0.743. The calibration curves for probability of 3- and 5-year OS indicated satisfactory agreement between nomogram-based prediction and actual observation. All results were confirmed in the validation cohort.
Conclusion
NPC patient with PLN metastasis had poorer survival outcome (OS, PFS, DMFS, and LRFS) than N3 disease. We developed a nomogram to provide individual prediction of OS for patients with PLN metastasis.

Citations

Citations to this article as recorded by  
  • Analysis of patients with parotid recurrence after parotid-sparing IMRT for nasopharyngeal carcinoma: case series and review of the literature
    Sezin Yuce Sari, Melek Tugce Yilmaz, Gozde Yazici, Sepideh Mohammadipour, Gokhan Ozyigit, Ibrahim Gullu, Mustafa Cengiz
    Strahlentherapie und Onkologie.2024; 200(12): 1057.     CrossRef
  • Nomogram Based on Liver Function Test Indicators for Survival Prediction in Nasopharyngeal Carcinoma Patients Receiving PD-1 Inhibitor Therapy
    Lixia Liang, Yan Li, Yansui Hong, Tianxing Ji, Hao Chen, Zhifang Lin
    Current Oncology.2023; 30(8): 7189.     CrossRef
  • A Randomized Controlled Trial on Evaluation of Plasma Epstein-Barr Virus Biomarker for Early Diagnosis in Patients With Nasopharyngeal Carcinoma
    Wen Liu, Huilan Li, Hui Sheng, Xiaohua Liu, Peidong Chi, Xueping Wang, Minjie Mao
    Advances in Therapy.2020; 37(10): 4280.     CrossRef
  • Prognosis prediction signature of seven immune genes based on HPV status in cervical cancer
    Qianqian Xia, Hua Jin, Xing Zhang, Wenjing Yan, Dan Meng, Bo Ding, Jian Cao, Dake Li, Shizhi Wang
    International Immunopharmacology.2020; 88: 106935.     CrossRef
  • 14,769 View
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  • 3 Web of Science
  • 4 Crossref
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Patterns of Failure and Survival Trends in 3,808 Patients with Stage II Nasopharyngeal Carcinoma Diagnosed from 1990 to 2012: A Large-Scale Retrospective Cohort Study
Xue-Song Sun, Di-Han Liu, Sai-Lan Liu, Qiu-Yan Chen, Shan-Shan Guo, Yue-Feng Wen, Li-Ting Liu, Hao-Jun Xie, Qing-Nan Tang, Yu-Jing Liang, Xiao-Yun Li, Jin-Jie Yan, Ming-Huang Hong, Jun Ma, Lin-Quan Tang, Hai-Qiang Mai
Cancer Res Treat. 2019;51(4):1449-1463.   Published online March 7, 2019
DOI: https://doi.org/10.4143/crt.2018.688
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to investigate the survival trends and patterns of failure in patients with stage II nasopharyngeal carcinoma (NPC) treated with radiotherapy (RT) and chemotherapy over the last 20 years.
Materials and Methods
Thirty-eight hundred and eight patients diagnosed with stage II NPC between January 1990 and December 2012 were involved in this retrospective cohort study. All patients were treated with RT. According to the main imaging techniques and RT technology, we categorized these patients into four calendar periods: 1990-1996, 1997-2002, 2003-2007, and 2008-2012. Overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS), and distant metastasis–free survival (DMFS) were served as the clinical outcome.
Results
After a median follow-up period of 84.7 months, we observed increasing trends in survival and disease control. The 3- and 5-year OS rates increased from 87.1% and 78.7% in the first calendar period to 97.4% and 94.5% in the last calendar period, respectively (p<0.001). Additionally, significant increasing trends could be seen in the PFS and LRFS during the four calendar periods. In the subgroup analysis, the LRFS in patients older than 50 years at diagnosis showed greater improvement than younger patients. However, the rate of distant metastasis was stable and relatively low, as the 5-year DMFS ranged from 90.5% to 94.7% among the four calendar periods.
Conclusion
The survival rates in patients with stage II NPC showed increasing trends from 1990 to 2012. The advance of RT provided excellent locoregional control and enhanced OS.

Citations

Citations to this article as recorded by  
  • ADAM22 acts as a novel predictive biomarker for unfavorable prognosis and facilitates metastasis via PI3K/AKT signaling pathway in nasopharyngeal carcinoma
    Kaixiong Xu, Ping Jiang, Zui Chen, Xiaoqiong Gu, Ting Zhang
    Pathology - Research and Practice.2024; 256: 155264.     CrossRef
  • T1-2N1M0 nasopharyngeal carcinoma chemotherapy or not: A retrospective study
    Pei-Jing Li, Ming Chen, Ye Tian, Seok Ho Lee
    PLOS ONE.2023; 18(3): e0279252.     CrossRef
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    Shi-Ting Huang, Dan-Ke Su
    Scientific Reports.2022;[Epub]     CrossRef
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    Susanna Hilda Hutajulu, Daniel Howdon, Kartika Widayati Taroeno-Hariadi, Mardiah Suci Hardianti, Ibnu Purwanto, Sagung Rai Indrasari, Camelia Herdini, Bambang Hariwiyanto, Ahmad Ghozali, Henry Kusumo, Wigati Dhamiyati, Sri Retna Dwidanarti, I. Bing Tan, J
    PLOS ONE.2021; 16(2): e0246638.     CrossRef
  • Explore the Usefulness of Concurrent Chemotherapy in Stage II Nasopharyngeal Carcinoma: A Retrospective Study
    Pei-Jing Li, Yu-Lin Lai, Fang He, Yuan-Yuan Chen, Zhuo-Sheng Gu, Wei Luo, Qun Zhang
    Frontiers in Pharmacology.2021;[Epub]     CrossRef
  • Systemic chemotherapy and sequential locoregional radiotherapy in initially metastatic nasopharyngeal carcinoma: Retrospective analysis with 821 cases
    Tianying Huang, Ning Su, Xuanye Zhang, Shuyun Ma, Guangzheng Zhong, Xiaopeng Tian, Qiuyan Chen, Linglong Tang, Lixia Lu, Yu Fang, Jun Cai, Qingqing Cai
    Head & Neck.2020; 42(8): 1970.     CrossRef
  • CD47 Overexpression Is Associated with Epstein–Barr Virus Infection and Poor Prognosis in Patients with Nasopharyngeal Carcinoma


    Zhi-Hui Wang, Xiao-Feng Pei, Zhi-Quan Zhu, Zhong Lin, Yin-Yan Mao, Xiao-Lu Xu, You-Li Luo, Li Zhang, Pei-Jian Peng
    OncoTargets and Therapy.2020; Volume 13: 3325.     CrossRef
  • Identification of miPEP133 as a novel tumor-suppressor microprotein encoded by miR-34a pri-miRNA
    Min Kang, Bo Tang, Jixi Li, Ziyan Zhou, Kang Liu, Rensheng Wang, Ziyan Jiang, Fangfang Bi, David Patrick, Dongin Kim, Anirban K. Mitra, Yang Yang-Hartwich
    Molecular Cancer.2020;[Epub]     CrossRef
  • 7,125 View
  • 154 Download
  • 9 Web of Science
  • 8 Crossref
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Subdivision of Nasopharyngeal Carcinoma Patients with Bone-Only Metastasis at Diagnosis for Prediction of Survival and Treatment Guidance
Xue-Song Sun, Yu-Jing Liang, Sai-Lan Liu, Qiu-Yan Chen, Shan-Shan Guo, Yue-Feng Wen, Li-Ting Liu, Hao-Jun Xie, Qing-Nan Tang, Xiao-Yun Li, Jin-Jie Yan, Lin-Quan Tang, Hai-Qiang Mai
Cancer Res Treat. 2019;51(4):1259-1268.   Published online January 4, 2019
DOI: https://doi.org/10.4143/crt.2018.652
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to subdivide M1 stage nasopharyngeal carcinoma (NPC) patients with bone-only metastases for prognosis prediction while identifying the treatment effect of locoregional radiotherapy (LRRT) and metastasis radiotherapy (MRT) among patients with different risk.
Materials and Methods
From November 2006 to October 2016, a total of 226 patients with bone-only metastasic NPC were retrospectively enrolled. All patients developed distant lesions before receiving treatment. All potential prognostic factors were considered and the correlation of the M1 subdivisions with overall survival (OS) was determined by Cox regression hazards model. Kaplan–Meier curves were used to appraise survival condition and log-rank testing was used to compare the differences.
Results
The median follow-up time was 33.9 months (range, 3 to 126 months). According to multivariate Cox proportional hazard analysis, the number of metastatic lesions and Epstein-Barr virus (EBV) DNA status after palliative chemotherapy (PCT) were independent prognostic factors for OS. Thus, we subdivided patients into three risk groups according to these two factors. Systemic chemotherapy combined with LRRT may benefit patients in low- and intermediate-risk groups but not in the high-risk group. Further aggressive MRT based on systemic chemotherapy showed no survival benefit in any risk group.
Conclusion
The stratification of NPC patients with bone-only metastasis based on EBV DNA after PCT and the number of metastatic lesions provided promising prognostic value and could aid clinicians in person-specific treatment.

Citations

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  • Efficacy of metastatic lesion radiotherapy in patients with metastatic nasopharyngeal carcinoma: A multicenter retrospective study
    Yang Liu, Jie Ma, Xiao-Yi Zeng, Zhi-Chao Zuo, Rui-Zhong Chen, Xiao-Yu Li, Zhong-Guo Liang, Kai-Hua Chen, Xin-Bin Pan, Su Pei, Bin-Bin Yu, Ling Li, Song Qu, Yun-Li Yang, Xiao-Dong Zhu
    Radiotherapy and Oncology.2024; 196: 110311.     CrossRef
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    Jian-Ji Pan, Hai-Qiang Mai, Wai Tong Ng, Chao-Su Hu, Jin-Gao Li, Xiao-Zhong Chen, James C. H. Chow, Edwin Wong, Victor Lee, Ling-Yu Ma, Qiao-Juan Guo, Qin Liu, Li-Zhi Liu, Ting-Ting Xu, Xiao-Chang Gong, Meng-Yun Qiang, Kwok-Hung Au, Tsz-Chim Liu, Chi Leun
    JAMA Oncology.2024;[Epub]     CrossRef
  • Whether Primary Bone‐Only Oligometastatic Nasopharyngeal Carcinoma Patients Benefit From Radiotherapy to the Bones on the Basis of Palliative Chemotherapy Plus Locoregional Radiotherapy?—A Large‐Cohort Retrospective Study
    Wan‐Ping Guo, Guo‐Dong Jia, Si‐Yi Xie, Xuan Yu, Xiao‐Han Meng, Lin‐Quan Tang, Xiao‐Yun Li, Dong‐Hua Luo
    Cancer Medicine.2024;[Epub]     CrossRef
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    Guo-Dong Jia, Xue-Song Sun, Xiao-Yun Li, Sai-Lan Liu, Jin-Hao Yang, Qiu-Yan Chen, Li Yuan, Hai-Qiang Mai
    BMC Cancer.2023;[Epub]     CrossRef
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    Yuting Fang, Shoucong Chen, Yuanfan Xu, Mengyun Qiang, Changjuan Tao, Shuang Huang, Lei Wang, Xiaozhong Chen, Caineng Cao
    Nuclear Medicine Communications.2023; 44(6): 457.     CrossRef
  • The map of bone metastasis in nasopharyngeal carcinoma: A real‐world study
    Dong‐Hua Luo, Jia‐Xin Li, Wan‐Ping Guo, Chen‐Guang Guo, Xiao‐Han Meng, Pei‐Jun Xie, Jie‐Yi Lin, Hao‐Yuan Mo, Qun Zhang, Yong Chen, Guo‐Ping Shen
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    Honggen Liu, Peiying Yang, Yingjie Jia
    European Archives of Oto-Rhino-Laryngology.2022; 279(2): 567.     CrossRef
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    Cheng Lin, Sheng Lin, Lili Zhu, Shaojun Lin, Jianji Pan, Yun Xu
    BMC Cancer.2022;[Epub]     CrossRef
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    Baoqiu Liu, Mingxing Zhang, Yanqing Cao, Zhe Wang, Xicheng Wang
    Scientific Reports.2022;[Epub]     CrossRef
  • Promising response to immunotherapy in metastatic nasopharyngeal carcinoma associated with hepatitis C virus – a case report
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    Fo‐Ping Chen, Xiao‐Dan Huang, Jia‐Wei Lv, Dan‐Wan Wen, Guan‐Qun Zhou, Li Lin, Jia Kou, Chen‐Fei Wu, Yue Chen, Zi‐Qi Zheng, Zhi‐Xuan Li, Xiao‐Jun He, Ying Sun
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    Qiaojuan Guo, Mengwei Chen, Hanchuan Xu, Tianzhu Lu, Han Zhou, Yanyan Chen, Jingfeng Zong, Yun Xu, Bijuan Chen, Bingyi Wang, Lili Zhu, Jianji Pan, Shaojun Lin
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    Cancer Management and Research.2020; Volume 12: 10211.     CrossRef
  • 8,062 View
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  • 21 Web of Science
  • 18 Crossref
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Induction Chemotherapy Plus Concurrent Chemoradiotherapy Versus Concurrent Chemoradiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma in Children and Adolescents: A Matched Cohort Analysis
Yang Li, Lin-Quan Tang, Li-Ting Liu, Shan-Shan Guo, Yu-Jing Liang, Xue-Song Sun, Qing-Nan Tang, Jin-Xin Bei, Jing Tan, Shuai Chen, Jun Ma, Chong Zhao, Qiu-Yan Chen, Hai-Qiang Mai
Cancer Res Treat. 2018;50(4):1304-1315.   Published online January 8, 2018
DOI: https://doi.org/10.4143/crt.2017.463
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to evaluate the long-term clinical outcome and toxicity of induction chemotherapy (IC) followed by concomitant chemoradiotherapy (CCRT) compared with CCRT alone for the treatment of children and adolescent locoregionally advanced nasopharyngeal carcinoma (LACANPC).
Materials and Methods
A total of 194 locoregionally advanced nasopharyngeal carcinoma patients youngerthan 21 years who received CCRT with or without IC before were included in the study population. Overall survival (OS) rate, progression-free survival (PFS) rate, locoregional recurrence-free survival (LRFS) rate, and distant metastasis-free survival (DMFS) rate were assessed by the Kaplan-Meier method and a log-rank test. Treatment toxicities were clarified and compared between two groups.
Results
One hundred and thiry of 194 patients received IC+CCRT. Patients who were younger and with more advanced TNM stage were more likely to receive IC+CCRT and intensive modulated radiotherapy. The addition of IC before CCRT failed to improve survival significantly. The matched analysis identified 43 well-balanced patients in both two groups. With a median follow-up of 51.5 months, no differences were found between the IC+CCRT group and the CCRT group in 5-year OS (83.7% vs. 74.6%, p=0.153), PFS (79.2% vs. 73.4%, p=0.355), LRFS (97.7% vs. 88.2%, p=0.083), and DMFS (81.6% vs. 81.6%, p=0.860). N3 was an independent prognostic factor predicting poorer OS, PFS, and DMFS. The addition of IC was associated with increased rates of grade 3 to 4 neutropenia.
Conclusion
This study failed to demonstrate that adding IC before CCRT could provide a significant additional survival benefit for LACANPC patients. Further investigations are warranted.

Citations

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    Tal Ben-Ami
    Journal of Pediatric Hematology/Oncology.2024; 46(3): 117.     CrossRef
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    Ya-Nan Jin, Zhao-Hui Ruan, Wan-Wei Cao, Lin Yang, Wei Yao, Xiao-Feng Pei, Wang-Jian Zhang, Tia Marks, Ji-Jin Yao, Liang-Ping Xia
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    JAMA Network Open.2022; 5(3): e220173.     CrossRef
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    Tao Xie, Kunpeng Du, Wei Liu, Chunshan Liu, Baiyao Wang, Yunhong Tian, Rong Li, Xiaoting Huang, Jie Lin, Haifeng Jian, Jian Zhang, Yawei Yuan
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Pretreatment Serum Amyloid A and C-reactive Protein Comparing with Epstein-Barr Virus DNA as Prognostic Indicators in Patients with Nasopharyngeal Carcinoma: A Prospective Study
Qiu-Yan Chen, Qing-Nan Tang, Lin-Quan Tang, Wen-Hui Chen, Shan-Shan Guo, Li-Ting Liu, Chao-Feng Li, Yang Li, Yu-Jing Liang, Xue-Song Sun, Ling Guo, Hao-Yuan Mo, Rui Sun, Dong-Hua Luo, Yu-Ying Fan, Yan He, Ming-Yuan Chen, Ka-Jia Cao, Chao-Nan Qian, Xiang Guo, Hai-Qiang Mai
Cancer Res Treat. 2018;50(3):701-711.   Published online July 14, 2017
DOI: https://doi.org/10.4143/crt.2017.180
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The measuring Epstein-Barr virus (EBV) DNA is an important predictor of nasopharyngeal carcinoma (NPC). This study evaluated the predictive value of pretreatment serum amyloid A (SAA) and C-reactive protein (CRP) comparing with EBV DNA in patients with NPC.
Materials and Methods
In an observational study of 419 non-metastatic NPC patients, we prospectively evaluated the prognostic effects of pretreatment SAA, CRP, and EBV DNA on survival. The primary endpoint was progress-free survival (PFS).
Results
The median level of SAA and CRP was 4.28 mg/L and 1.88 mg/L, respectively. For the highSAA group (> 4.28 mg/L) versus the low-SAA (≤ 4.28 mg/L) group and the high-CRP group (> 1.88 mg/L) versus the low-CRP (≤ 1.88 mg/L) group, the 5-year PFS was 64.5% versus 73.1% (p=0.013) and 65.2% versus 73.3% (p=0.064), respectively. EBV DNA detection showed a superior predictive result, the 5-year PFS in the EBV DNA ≥ 1,500 copies/mL group was obviously different than the EBV DNA < 1,500 copies/mL group (62.2% versus 77.8%, p < 0.001). Multifactorial Cox regression analysis confirmed that in the PFS, the independent prognostic factors were including EBV DNA (hazard ratio [HR], 1.788; p=0.009), tumour stage (HR, 1.903; p=0.021), and node stage (HR, 1.498; p=0.049), but the SAA and CRP were not included in the independent prognostic factors.
Conclusion
The results of SAA and CRP had a certain relationship with the prognosis of NPC, and the prognosis of patients with high level of SAA and CRP were poor. However, the predictive ability of SAA and CRP was lower than that of EBV DNA.

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