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Impact of primary tumor volume and location on the prognosis of patients with locally recurrent nasopharyngeal carcinoma.

Tian YM, Xiao WW, Bai L, Liu XW, Zhao C, Lu TX, Han F - Chin J Cancer (2015)

Bottom Line: Magnetic resonance (MR) images for 229 patients with locally recurrent NPC who underwent IMRT were analyzed retrospectively.There was a difference in the survival between patients with T1 and T2 diseases (77.6% vs. 50.0%, P<0.01) and those with T3 and T4 diseases (33.0% vs. 18.0%, P=0.04) but no difference between patients with T2 and T3 diseases (50.0% vs. 33.0%, P=0.18).This new system can be used to guide the treatment strategy for different risk groups of recurrent NPC.

View Article: PubMed Central - PubMed

Affiliation: Huizhou Municipal Central Hospital, Huizhou, Guangdong, 516001, People's Republic of China. tianyunmingzlyy@126.com.

ABSTRACT

Introduction: The properties of a tumor itself were considered the main factors determining the survival of patients with locally recurrent nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). However, recurrent tumors were mainly evaluated by using the American Joint Committee on Cancer staging system, which was modeled on primary tumors and did not incorporate the tumor volume. This study aimed to investigate the prognostic values of the primary tumor location and tumor volume, and to determine whether evaluating these parameters could improve the current staging system.

Methods: Magnetic resonance (MR) images for 229 patients with locally recurrent NPC who underwent IMRT were analyzed retrospectively.

Results: The skull base, parapharyngeal space, and intracranial cavity were the most common sites of tumors. There was a difference in the survival between patients with T1 and T2 diseases (77.6% vs. 50.0%, P<0.01) and those with T3 and T4 diseases (33.0% vs. 18.0%, P=0.04) but no difference between patients with T2 and T3 diseases (50.0% vs. 33.0%, P=0.18). Patients with a tumor volume≤38 cm3 had a significantly higher survival rate compared with those with a tumor volume>38 cm3 (48.7% vs. 15.2%, P<0.01).

Conclusions: A new staging system has been proposed, with T3 tumors being down-staged to T2 and with the tumor volume being incorporated into the staging, which may lead to an improved evaluation of these tumors. This new system can be used to guide the treatment strategy for different risk groups of recurrent NPC.

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Related in: MedlinePlus

Survival curves for NPC patients with different factors. a, patients with the recurrent T category determined according to the American Joint Committee on Cancer (AJCC) staging system; b, patients stratified by the tumor volume; c, patients with the recurrent T category determined according to the proposed staging system (Tn*); d, receiver operator characteristic (ROC) curves for the recurrent T category alone, the tumor volume alone, and the addition of the tumor volume to the recurrent T category in the proposed staging system
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Fig3: Survival curves for NPC patients with different factors. a, patients with the recurrent T category determined according to the American Joint Committee on Cancer (AJCC) staging system; b, patients stratified by the tumor volume; c, patients with the recurrent T category determined according to the proposed staging system (Tn*); d, receiver operator characteristic (ROC) curves for the recurrent T category alone, the tumor volume alone, and the addition of the tumor volume to the recurrent T category in the proposed staging system

Mentions: Based on the invasion sites, recurrent tumors were evaluated according to the 2009 AJCC staging system. The 5-year OS rates for patients with T1, T2, T3, and T4 tumors were 77.6 %, 50.0 %, 33.0 %, and 18.0 %, respectively. The survival rates were significantly different between the patients with T1 and T2 tumors (P < 0.01) and between those with T3 and T4 tumors (P = 0.04). However, the difference in survival rates between the patients with T2 and T3 tumors was not significant (P = 0.18; Fig. 3a).Fig. 3


Impact of primary tumor volume and location on the prognosis of patients with locally recurrent nasopharyngeal carcinoma.

Tian YM, Xiao WW, Bai L, Liu XW, Zhao C, Lu TX, Han F - Chin J Cancer (2015)

Survival curves for NPC patients with different factors. a, patients with the recurrent T category determined according to the American Joint Committee on Cancer (AJCC) staging system; b, patients stratified by the tumor volume; c, patients with the recurrent T category determined according to the proposed staging system (Tn*); d, receiver operator characteristic (ROC) curves for the recurrent T category alone, the tumor volume alone, and the addition of the tumor volume to the recurrent T category in the proposed staging system
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4593352&req=5

Fig3: Survival curves for NPC patients with different factors. a, patients with the recurrent T category determined according to the American Joint Committee on Cancer (AJCC) staging system; b, patients stratified by the tumor volume; c, patients with the recurrent T category determined according to the proposed staging system (Tn*); d, receiver operator characteristic (ROC) curves for the recurrent T category alone, the tumor volume alone, and the addition of the tumor volume to the recurrent T category in the proposed staging system
Mentions: Based on the invasion sites, recurrent tumors were evaluated according to the 2009 AJCC staging system. The 5-year OS rates for patients with T1, T2, T3, and T4 tumors were 77.6 %, 50.0 %, 33.0 %, and 18.0 %, respectively. The survival rates were significantly different between the patients with T1 and T2 tumors (P < 0.01) and between those with T3 and T4 tumors (P = 0.04). However, the difference in survival rates between the patients with T2 and T3 tumors was not significant (P = 0.18; Fig. 3a).Fig. 3

Bottom Line: Magnetic resonance (MR) images for 229 patients with locally recurrent NPC who underwent IMRT were analyzed retrospectively.There was a difference in the survival between patients with T1 and T2 diseases (77.6% vs. 50.0%, P<0.01) and those with T3 and T4 diseases (33.0% vs. 18.0%, P=0.04) but no difference between patients with T2 and T3 diseases (50.0% vs. 33.0%, P=0.18).This new system can be used to guide the treatment strategy for different risk groups of recurrent NPC.

View Article: PubMed Central - PubMed

Affiliation: Huizhou Municipal Central Hospital, Huizhou, Guangdong, 516001, People's Republic of China. tianyunmingzlyy@126.com.

ABSTRACT

Introduction: The properties of a tumor itself were considered the main factors determining the survival of patients with locally recurrent nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). However, recurrent tumors were mainly evaluated by using the American Joint Committee on Cancer staging system, which was modeled on primary tumors and did not incorporate the tumor volume. This study aimed to investigate the prognostic values of the primary tumor location and tumor volume, and to determine whether evaluating these parameters could improve the current staging system.

Methods: Magnetic resonance (MR) images for 229 patients with locally recurrent NPC who underwent IMRT were analyzed retrospectively.

Results: The skull base, parapharyngeal space, and intracranial cavity were the most common sites of tumors. There was a difference in the survival between patients with T1 and T2 diseases (77.6% vs. 50.0%, P<0.01) and those with T3 and T4 diseases (33.0% vs. 18.0%, P=0.04) but no difference between patients with T2 and T3 diseases (50.0% vs. 33.0%, P=0.18). Patients with a tumor volume≤38 cm3 had a significantly higher survival rate compared with those with a tumor volume>38 cm3 (48.7% vs. 15.2%, P<0.01).

Conclusions: A new staging system has been proposed, with T3 tumors being down-staged to T2 and with the tumor volume being incorporated into the staging, which may lead to an improved evaluation of these tumors. This new system can be used to guide the treatment strategy for different risk groups of recurrent NPC.

Show MeSH
Related in: MedlinePlus