Distant metastases of nasopharyngeal carcinoma: A study of 256 male patients

Ahmad, Anwar; Stefani, Stefano S.

doi:10.1002/jso.2930330310

Cited by 175 publications

(115 citation statements)

References 20 publications

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“…The most common histological variant was the undifferentiated carcinoma (WHO Type III). The incidence of distant metastasis at presentation, which was 33 % in our series, is similar to world series [5]. All recurrences/ relapse were noted within 3 year of diagnosis, this was also comparable to the global data [6].…”

Section: Discussionsupporting

confidence: 90%

Paediatric Nasopharyngeal Carcinoma: An 8-Year Study from a Tertiary Care Cancer Centre in South India

Guruprasad

Tanvir

Rohan

et al. 2013

Indian J Otolaryngol Head Neck Surg

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Nasopharyngeal carcinoma (NPC) accounts for less than 1 % of all paediatric cancers. Advances in imaging, radiation delivery, chemotherapy and improvement in multidisciplinary care have resulted in drastic changes in the outcome of this disease. Since NPC is extremely rare in paediatric population and there is paucity of data in Indian patients, we conducted the present study to analyze the outcome of paediatric NPC. Eighteen patients aged 18 years or less, who had pathologically proven diagnosis of NPC and had received treatment at our institute from 2003 to 2010 was included for analysis. These patients were treated with radiotherapy and chemotherapy. Event free survival, local and systemic relapse and progression were analysed. These outcomes were correlated with age, radiation dose and the stage of disease. Majority of patients presented with advanced stage and poor histological grade (94.4 % had WHO Type III disease). The median follow up was 38 months (range 3-91 months). The estimated event free survival at a follow up of 5 years was 64.28 %. Distant metastasis at presentation and lower radiation dose were predictive of poor outcome. Paediatric NPC usually presents in an advanced stage. Our results are comparable to studies which have used only chemoradiotherapy, are far inferior to studies which have used chemoradiotherapy and adjuvant immunotherapy. Larger prospective studies are required to define the role of adjuvant immunotherapy, the optimum dose and schedule of chemoradiotherapy and role of new agents like cetuximab in Indian paediatric patients.

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Section: Discussionsupporting

confidence: 90%

Paediatric Nasopharyngeal Carcinoma: An 8-Year Study from a Tertiary Care Cancer Centre in South India

Guruprasad

Tanvir

Rohan

et al. 2013

Indian J Otolaryngol Head Neck Surg

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“…This is especially true for patients who present with locally advanced disease (Ahmad and Stefani, 1986). A prospective study showed a high rate of subclinical distant metastasis, with a distinctive feature of bone marrow invasion (Micheau et al, 1987).…”

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confidence: 99%

Validation of a new prognostic index score for disseminated nasopharyngeal carcinoma

Toh

Heng

et al. 2005

Br J Cancer

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Patients with metastatic nasopharyngeal carcinoma have variable survival outcomes. We previously designed a scoring system to better prognosticate these patients. Here, we report results on validation of this new prognostic index score in a separate cohort of patients. Clinical features and laboratory parameters were examined in 172 patients with univariate and multivariate analyses and a numerical score was derived for each independent prognostic variable. Significant independent prognostic variables and their scores assigned included poor performance status (score 5), haemoglobin o12 g dl À1 (score 4) and disease-free interval (DFI) (DFIp6 months (score 10) or metastases at initial diagnosis (score 1)). Maximum score was 19 and patients stratified into three prognostic groups: good, 0 -3; intermediate, 4 -8; poor, X9. When applied to a separate cohort of 120 patients, 59 patients were good, 43 intermediate and 18 poor prognosis, with median survivals of 19.6 (95% CI 16.1, 23.1), 14.3 (95% CI 12.3, 16.2) and 7.9 (95% CI 6.6, 9.2) months, respectively. (logrank test: P ¼ 0.003). We have validated a new prognostic score with factors readily available in the clinics. This simple score will prove useful as a method to prognosticate and stratify patients as well as to promote consistent reporting among clinical trials.

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“…It remained the major cause of death, despite the improving locoregional control. Two decades ago, a retrospective review and an autopsy study of patients with NPC has found that the overall incidence of distant metastasis was 36% [13] . In the report, liver was the most common site of involvement.…”

Section: Discussionmentioning

confidence: 99%

“…In the presence of locoregionally advanced tumor, the use of concurrent chemoradiation was shown to be superior compared to radiotherapy alone, either in terms of improvement in local and regional control [3][4][5] , or reduced risk of distant failure [3,[6][7] . In a study involving 256 patients with NPC, the incidence of systemic metastasis was up to 36% [8] , the most common sites of which being the bones, lungs and the liver. Data on the treatment of distant failures after radiotherapy for NPC is limited.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive treatment of oligometastasis in the liver in recurrent nasopharyngeal carcinoma

Chan¹

2016

J Nasopharyng Carcinoma

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Objective:The principle of management of patients with oligometastasis is evolving. The current study aims to investigate theefficacy of percutaneous radiofrequency ablation (RFA) of the solitary liver metastasis after previous radiotherapy for nasopharyngeal carcinoma (NPC). Methods: A pilot study involving 4 patients with biopsy proven solitary liver metastasis from NPC. After creation of artificial ascites, cooltip RFA needle was inserted into the intra-hepatic tumor under ultrasound guidance. Procedure related complications were noted and patients were followed up regularly and indefinitely for oncological outcome. Results: All patients had locoregionally advanced NPC at initial diagnosis and were treated with concurrent chemoradiation. Complete response was achieved in all patients. The mean time to tumor recurrence was 21.3 months. The mean size of the liver tumor was 3.5cm. Two patients had synchronous local tumor recurrence, and they underwent nasopharyngectomy and neck dissection before receiving treatment to the liver. Percutaneous RFA was performed in all patients. The mean hospital stay was 2.2 days and no procedure related complications were detected. No systemic treatment was given afterwards. The mean follow-up interval was 40.5 months. One of the patients developed progression of disease and died at 13 months after RFA, while the rest of the patients were alive and remained disease free at the last follow-up. Conclusion: Percutaneous RFA is potentially useful as a minimally invasive procedure for patients with solitary liver metastasis after radiotherapy for NPC. Further study is required to confirm its efficacy and to define the protocol of adjuvant systemic chemotherapy to improve the treatment outcome.

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Distant metastases of nasopharyngeal carcinoma: A study of 256 male patients

Cited by 175 publications

References 20 publications

Paediatric Nasopharyngeal Carcinoma: An 8-Year Study from a Tertiary Care Cancer Centre in South India

Paediatric Nasopharyngeal Carcinoma: An 8-Year Study from a Tertiary Care Cancer Centre in South India

Validation of a new prognostic index score for disseminated nasopharyngeal carcinoma

Minimally invasive treatment of oligometastasis in the liver in recurrent nasopharyngeal carcinoma

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