Retrograde Analysis of Clinical Characteristics of Bone Metastasis in 1,031 Cases of Preliminarily Diagnosed Nasopharyngeal Carcinoma

Zhao, Chen; Qian, Guo-Qiang; Chen, Xiaoyin; Chen, Chao

doi:10.7314/apjcp.2014.15.8.3785

Cited by 12 publications

(16 citation statements)

References 19 publications

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“… 8 Bone metastasis is one of the predominant failure sites of NPC, the treatment outcome of which is far from satisfactory. 8 11 12 13 Our series indicated a median OMS time of 26.5 months, with a 2-year OMS rate of 52%. Multivariate analysis identified MFI, numbers of bone metastasis, S-LDH level, and treatment modality as significant prognosticators.…”

Section: Discussionmentioning

confidence: 60%

“…Several studies have evaluated the survival and prognostic factors of NPC patients with bone metastasis. 11 12 13 16 A recent report from China indicated a median OMS of 12 months, in which 70 NPC patients with bone metastasis at their first visit were enrolled. 12 Among them, 29 co-existed with other metastatic sites, including lung and/or liver, althgouh no further prognostic analysis were performed in this series.…”

Section: Discussionmentioning

confidence: 99%

“…Therein, the median overall metastasis survival (OMS) time is reported to be 12–23.5 months. 11 12 13 These data indicate that bone metastasis patients may differ greatly in terms of survival; however, methods have not yet to be developed for evaluating prognoses and stratifying these patients into different risk groups before treatment, especially those with bone-only metastasis after definitive CRT.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Evaluation of Nasopharyngeal Carcinoma with Bone-Only Metastasis after Therapy

Guo

Cui

et al. 2016

Yonsei Med J

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PurposeTo evaluate the prognosis of nasopharyngeal carcinoma (NPC) patients who developed bone-only metastasis after primary treatment and the stratification of these patients into different risk groups based on independent prognostic factors.Materials and MethodsEighty NPC patients who developed bone-only metastasis after definitive radiotherapy from October 2005 to December 2010 were enrolled. All these patients received palliative treatment for bone metastasis, including chemotherapy and/or radiotherapy. Clinical features, treatment modality, and laboratory parameters were examined with univariate and multivariate analyses.ResultsThe median follow-up time was 15.5 months (range, 2–67 months) for the whole cohort. The median overall metastatic survival (OMS) time and the 2-year estimate OMS rate were 26.5 months and 52%, respectively. Multivariate analysis indicated that patients with short metastases-free interval, multiple bone metastases sites, high serum lactic dehydrogenase levels, and treated with radiotherapy or chemotherapy alone had significantly worse outcomes. Patients were stratified into three different risk groups based on the number of adverse factors present. The OMS curves of the three groups were all significantly different (p<0.001).ConclusionSeverl prognostic factors were found to be associated with worse outcomes. According to the number of adverse factors present, bone-only metastasis patients can be stratified into three risk groups with significantly different prognoses. Such grouping may help in improving the design of clinical trials and in guiding individualized treatment for NPC patients with bone-only metastasis.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic Evaluation of Nasopharyngeal Carcinoma with Bone-Only Metastasis after Therapy

Guo

Cui

et al. 2016

Yonsei Med J

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“…Bone metastases have even been reported in the femora and the feet[11] and as such some metastases in our study may have been outside the field of view of the scans.…”

Section: Discussionmentioning

confidence: 89%

18F-fluorodeoxyglucose-positron emission tomography/computed tomography imaging of metastatic nasopharyngeal cancer with emphasis on the distribution of bone metastases

Tamimi

Zaheer

et al. 2017

World J Nucl Med

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Distant metastases change the prognosis of patients with nasopharyngeal carcinoma (NPC) which most commonly metastasizes to the bone. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is reported as useful in imaging NPC metastases. Our study assesses the incidence and distribution of bone metastases detected by 18F-FDG PET/CT in NPC. 717 18F-FDG PET/CT scan reports of histologically proven NPC patients imaged in Singapore General Hospital, Singapore, between 2003 and 2009 were reviewed for the total number of metastases (scanned from vertex to mid-thigh) and analyzed for distribution. Of the 709 FDG avid metastases in these reports, 357/709 (50.35%) were locoregional nodal metastasis and 352/709 (49.65%) were distant metastases of which 192/709 (27.08%) of total metastases and 54.54% of distant metastases (192/352) were in the bones. The majority of the bone lesions 125/192 (65.1%) were in the axial skeleton with 109/192 (56.77%) in the lower skeleton (thoracolumbar spine, sacrum, and pelvis). The incidence of bone metastases in our study (27.08%) was higher than that reported in other studies, for example, 15% by Liu et al. and 11% (230 patients) by Caglar et al. Bone metastases have been reported in the femurs and the feet and as such some metastases may have been outside the field of view of the scans. In our study, 27% of FDG avid NPC metastases are in the bones.

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“…The most common sites of metastasis are bones, followed by lungs, liver and distant lymph nodes. 78.3% patients occurred bone metastasis within 2 years after diagnosis of NPC, the overall survival time after bone metastasis is 6–24 months with a median of 12 months and the median survival time for patients who accepted alleviative treatment is merely 4 months [ 19 ]. Lung is the second common site of metastasis of NPC, patients with lung metastasis alone had a median overall survival of 3.9 years, which is significantly longer than that of other metastasis sites [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Partial hepatectomy for liver metastases from nasopharyngeal carcinoma: a comparative study and review of the literature

Huang

Zheng

et al. 2014

BMC Cancer

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BackgroundThe management of liver metastases from nasopharyngeal carcinoma (NPC) has not been extensively investigated. This study aimed to compare the long-term outcome of patients with liver metastases from NPC who were treated by a partial hepatectomy or transcatheter hepatic artery chemoembolization (TACE).MethodsBetween January 1993 and December 2010, 830 patients were diagnosed with liver metastases from NPC and exhibited a complete response to the primary cancer of the nasopharynx and regional lymph nodes. Fifteen patients with intrahepatic metastasis underwent R0 partial hepatectomy. As a parallel control group, another 15 patients with a resectable liver metastasis who underwent TACE were selected. Prior to the resection and TACE that were performed on patients in these two groups, radical radiotherapy with or without adjuvant chemotherapy was administered. Clinicopathological data and treatment outcomes were compared retrospectively.ResultsNo significant differences were observed between the two groups in terms of the clinicopathological features, which include gender ratio, liver function, accompanying cirrhosis, rate of infection with the hepatitis B virus, tumor size, tumor number, pathological type and preoperative comorbidities. The 1-, 3- and 5-year overall survival rates from the time of hepatectomy were 85.7%, 64.2% and 40.2%, respectively, with a median survival of 45.2 months, whereas the 1-, 3- and 5-year overall survival rates were 53.3%, 26.6% and 20.0% for patients in the control group (P = 0.039), respectively, with a median survival of 14.1 months. The actuarial median progression-free survival (PFS) of the patients in the resection group was 21.2 months, and the 1-, 3- and 5-year PFS rates were 70%, 53% and 18%, respectively. In the control group, the 1-, 3- and 5-year PFS rates were 27%, 7% and 0.0% (P = 0.007), respectively, with a median survival of 4.2 months. Thus far, 5 patients have survived for more than 5 years, and the longest survival time is 168.1 months.ConclusionsFor patients with limited liver metastases from NPC, hepatectomy provides a survival advantage over TACE. Due to the limited treatment options for patients with liver metastasis from NPC, hepatectomy should be recommended as an optimal treatment. Moreover, perioperative chemotherapy may be associated with an improved prognosis.

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Retrograde Analysis of Clinical Characteristics of Bone Metastasis in 1,031 Cases of Preliminarily Diagnosed Nasopharyngeal Carcinoma

Cited by 12 publications

References 19 publications

Prognostic Evaluation of Nasopharyngeal Carcinoma with Bone-Only Metastasis after Therapy

Prognostic Evaluation of Nasopharyngeal Carcinoma with Bone-Only Metastasis after Therapy

18F-fluorodeoxyglucose-positron emission tomography/computed tomography imaging of metastatic nasopharyngeal cancer with emphasis on the distribution of bone metastases

Partial hepatectomy for liver metastases from nasopharyngeal carcinoma: a comparative study and review of the literature

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