Prognostic stratification of patients with metastatic nasopharyngeal carcinoma using a clinical and biochemical scoring system

• Published in: Journal of cancer research and clinical oncology Vol. 143; no. 12; pp. 2563 - 2570
• Main Authors: Chee, Jeremy, Loh, Kwok Seng, Tham, Ivan, Ho, Francis, Wong, Lea Choung, Tan, Chee Seng, Goh, Boon Cher, Lim, Chwee Ming
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2017; Springer Nature B.V
• Subjects: Cancer Research; Carcinoma - diagnosis; Carcinoma - pathology; Carcinoma - therapy; Cohort Studies; Disease control; Female; Hematology; Hemoglobin; Humans; Internal Medicine; Male; Medical prognosis; Medicine; Medicine & Public Health; Metastases; Metastasis; Middle Aged; Multivariate Analysis; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms - diagnosis; Nasopharyngeal Neoplasms - pathology; Nasopharyngeal Neoplasms - therapy; Neoplasm Metastasis; Oncology; Original Article – Clinical Oncology; Palliative Care - methods; Prognosis; Retrospective Studies; Risk groups; Survival; Throat cancer; Nasopharyngeal carcinoma; Prognostic factor; Metastatic; Advanced; Prognostic score
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-017-2496-1

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.