Retrospective analysis of 5037 patients with nasopharyngeal carcinoma treated during 1976–1985: Overall survival and patterns of failure

Lee, Anne W.M.; Poon, Y.F.; Foo, William; Law, Stephen C.K.; Cheung, Fanny M.; Chan, David; Tung, Stewart Y.; Thaw, Myo; Ho, J. H. C.

doi:10.1016/0360-3016(92)90740-9

Cited by 619 publications

(388 citation statements)

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“…Lee et al reported that 891 of 4779 patients with NPC who had achieved complete disease remission after irradiation for at least 6 months developed true local recurrences, with a median latent interval of 20.4 months. 1 Tune et al reported a sample of 32 radiationtreated patients. Of nine patients with recurrent or residual disease, only two patients were positive for EBV; therefore, scarring change after irradiation may reduce the overall ability of nasopharyngeal brushing to detect EBV positivity in patients with recurrent NPC.…”

Section: Discussionmentioning

confidence: 99%

“…1,4,5 Recurrent tumors of the nasopharynx can be treated again with radiotherapy, or radiotherapy can be combined with other treatment modalities. 6,7 Recently, more advanced radiation techniques, such as three-dimensional conformal radiotherapy with or without radiosurgery and intensity-modulated radiotherapy, have been developed that can provide more accurate dosimetric distribution for recurrent nasopharyngeal tumors and can spare previously irradiated normal tissues, particularly if the recurrent lesion is small.…”

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confidence: 99%

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Presence of the latent membrane protein 1 gene in nasopharyngeal swabs from patients with mucosal recurrent nasopharyngeal carcinoma

Tsang

Chuang

Tseng

et al. 2003

Cancer

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BACKGROUNDNasopharyngeal carcinoma (NPC) is the most common head and neck malignancy in southeastern China and Taiwan. Early detection of the local disease followed by timely and appropriate treatment is essential to increasing cure and survival rates. Detection of Epstein–Barr virus (EBV) genomic DNA, such as the latent membrane protein 1 gene (LMP‐1), in patients postirradiation during follow‐up may indicate mucosal recurrence.METHODSSeventy‐one patients with NPC underwent serial nasopharyngeal swabs for LMP‐1 polymerase chain reaction assay before, during, and after irradiation. All of patients achieved a complete disease remission of the LMP‐1 gene after irradiation that lasted for at least 6 months.RESULTSThe median LMP‐1 disease remission time after the beginning of irradiation was 4.3 weeks. Patients with early LMP‐1 disease remission (≤ 4 weeks after the beginning of irradiation) and delayed LMP‐1 disease remission (> 4 weeks) had 3‐year local control rates of 93.5% and 76.9%, respectively (P = 0.0529). The LMP‐1 gene was detected again (reexpression of LMP‐1 [re‐LMP‐1]) in 10 patients after irradiation with at least 6 months of follow‐up. Nine of 10 patients (90%) in the re‐LMP‐1 positive group and 2 of 61 patients (3.3%) in the re‐LMP‐1 negative group developed local recurrence. Mucosal recurrence developed in nine patients, and all displayed re‐LMP‐1. By detecting re‐LMP‐1 using nasopharyngeal swabs, mucosal recurrence was diagnosed with a sensitivity of 100% (9 of 9 patients) and a specificity of 98.4% (61 of 62 patients). The 3‐year overall survival rate, the disease free survival rate for the entire group, and the estimated local mucosal control rates in the re‐LMP‐1 positive and re‐LMP‐1 negative groups were 86.5%, 76.5%, 19.4%, and 96.7%, respectively.CONCLUSIONSExpression of EBV LMP‐1 in nasopharyngeal swab specimens from patients with irradiated/treated NPC can provide a highly sensitive and specific method of forecasting mucosal recurrence. This investigation confirmed the reliability and feasibility of nasopharyngeal swabs in screening for mucosal recurrences in patients with NPC. Cancer 2003. © 2003 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Presence of the latent membrane protein 1 gene in nasopharyngeal swabs from patients with mucosal recurrent nasopharyngeal carcinoma

Tsang

Chuang

Tseng

et al. 2003

Cancer

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“…Under the current treatment regimens, the survival rates among nasopharyngeal carcinoma patients are B92% at 1 year and B50% at 5 years, with 20-25% of patients eventually developing distant metastases. 9,10 Nasopharyngeal carcinoma is generally sensitive to radiation therapy, but more advanced cases may require a combination of radiotherapy and chemotherapy. 11 Thus, it is essential for us to develop more effective diagnostic and therapeutic strategies against nasopharyngeal carcinoma.…”

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confidence: 99%

A novel role for TNFAIP2: its correlation with invasion and metastasis in nasopharyngeal carcinoma

Chen

et al. 2011

Modern Pathology

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Tumor necrosis factor alpha (TNFa) is an inflammatory cytokine that is present in the microenvironment of many tumors and is known to promote tumor progression. To examine how TNFa modulates the progression and metastasis of nasopharyngeal carcinoma, we used Affymetrix chips to identify TNFa-inducible genes that are dysregulated in this tumor. Elevated expression of TNFAIP2, which encodes TNFa-inducible protein 2 and not previously known to be associated with cancer, was found and confirmed by quantitative RT-PCR of TNFAIP2 expression in nasopharyngeal carcinoma and adjacent normal tissues. Immunohistochemical analysis showed that the TNFAIP2 protein was highly expressed in tumor cells. Analysis of 95 nasopharyngeal carcinoma biopsy specimens revealed that high TNFAIP2 expression was significantly correlated with highlevel intratumoral microvessel density (P ¼ 0.005) and low distant metastasis-free survival (P ¼ 0.001). A multivariate analysis further confirmed that TNFAIP2 was an independent prognostic factor for nasopharyngeal carcinoma (P ¼ 0.002). In vitro, TNFa treatment of nasopharyngeal carcinoma HK1 cells was found to induce TNFAIP2 expression, and siRNA-based knockdown of TNFAIP2 dramatically reduced the migration and invasion of nasopharyngeal carcinoma HK1 cells. These results collectively suggest for the first time that TNFAIP2 is a cell migration-promoting protein and its expression predicts distant metastasis. Our data suggest that TNFAIP2 may serve as an independent prognostic indicator for nasopharyngeal carcinoma.

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“…A prospective study showed a high rate of subclinical distant metastasis, with a distinctive feature of bone marrow invasion (Micheau et al, 1987). In addition, the incidence of distant failure after radiotherapy treatment for locally advanced disease can be as high as 57% in N 3 disease (Lee et al, 1992). In view of the high rate of systemic relapse, chemotherapy has been incorporated into the primary treatment of locally advanced disease in order to improve the outcome.…”

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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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Retrospective analysis of 5037 patients with nasopharyngeal carcinoma treated during 1976–1985: Overall survival and patterns of failure

Cited by 619 publications

References 36 publications

Presence of the latent membrane protein 1 gene in nasopharyngeal swabs from patients with mucosal recurrent nasopharyngeal carcinoma

Presence of the latent membrane protein 1 gene in nasopharyngeal swabs from patients with mucosal recurrent nasopharyngeal carcinoma

A novel role for TNFAIP2: its correlation with invasion and metastasis in nasopharyngeal carcinoma

Validation of a new prognostic index score for disseminated nasopharyngeal carcinoma

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