Clinical Research Papers:
Age at diagnosis indicated poor prognosis in locoregionally advanced nasopharyngeal carcinoma
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Lu-Ning Zhang1,2,*, Xing-Sheng Qiu3,*, Pu-Yun OuYang2,*, Yao Xiao2, Xiao-Wen Lan2, Wuguo Deng2, Fang-Yun Xie2 and Xi-Cheng Wang1
1 Department of Oncology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
2 Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
3 Department of Radiation Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
* Co-first authors
Correspondence to:
Xi-Cheng Wang, email:
Fang-Yun Xie, email:
Wuguo Deng, email:
Keywords: age; concurrent chemoradiotherapy; distant metastasis; mortality; nasopharyngeal carcinoma
Received: August 10, 2016 Accepted: September 29, 2016 Published: October 09, 2016
Abstract
Background: Effect of age at diagnosis on treatment failure and mortality was rarely evaluated in nasopharyngeal carcinoma.
Methods: We analyzed 1252 patients staged III-IVb and underwent concurrent chemoradiotherapy. Age was categorized as 20 to 49 years (n=804), 50 to 59 years (n=282) and 60 years or older (n=166). Distant metastasis-free survival (DMFS), cancer-specific survival (CSS), overall survival (OS) and locoregional relapse-free survival (LRFS) were assessed by age group.
Results: The 4-years DMFS decreased with age group (86.7% [20-49 years], 86.7% [50-59 years], 77.1% [≥60 years]; P=0.014); likewise, 4-years CSS were 91.0%, 87.4% and 74.2% (P<0.001); 4-years OS were 90.8%, 87.4% and 73.6% (P<0.001), respectively. In multivariate analysis, compared with patients aged 20 to 49 years, DMFS decreased with age for patients aged 50 to 59 years (HR=1.10, 95% CI 0.77-1.57) and aged 60 years or older (HR=1.75, 95% CI 1.20-2.56) (P=0.015). Similarly, both CSS and OS were inferior in patients aged 50 to 59 years (HR=1.77, 95% CI 1.25-2.52 for CSS; HR=1.71, 95% CI 1.21-2.43 for OS) and aged 60 or older (HR=3.73, 95% CI 2.63-5.29 for CSS; HR=3.96, 95% CI 2.83-5.54 for OS) (P<0.001). Yet age did not affect LRFS in univariate and multivariate analysis.
Conclusions: Increasing age at diagnosis of locoregionally advanced nasopharyngeal carcinoma was associated with higher risk of distant metastasis and mortality.