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Article: Prognostic value of paranasopharyngeal extension of nasopharyngeal carcinoma: A significant factor in local control and distant metastasis

TitlePrognostic value of paranasopharyngeal extension of nasopharyngeal carcinoma: A significant factor in local control and distant metastasis
Authors
Keywordsdistant metastasis
local control
nasopharyngeal carcinoma
paranasopharyngeal extension
prognostic factor
Issue Date1996
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741
Citation
Cancer, 1996, v. 78 n. 2, p. 202-210 How to Cite?
AbstractBACKGROUND. This study was conducted to evaluate the prognostic value of paranasopharyngeal extension in local control and distant metastasis in patients with nasopharyngeal carcinoma. METHODS. Three hundred and sixty- four patients with newly diagnosed nasopharyngeal carcinoma without distant metastasis were reviewed. Patients were staged according to Ho's staging system. Using a semiquantitative method, tumor extension into the paranasopharyngeal space was graded as: 0: no extension; 1:-extension to the retrostyloid space; 2:-extension to the prestyloid space; and 3:-extension to the anterior part of the masticator space. All patients received radiotherapy as primary treatment. Median follow-up time was 45 months (range, 4.7 to 76.5 months). Relapse free, local relapse free, and distant metastasis free survival were estimated using the Kaplan-Meier method. Cox regression was also performed to adjust for prognostic factors. RESULTS. The incidence of paranasopharyngeal extension was high (72.5%). Of these patients, 65.5% had Grade 2 or 3 extension. The 5-year relapse free survival rates for Grade 0, 1, 2, and 3 extension were 76%, 70%, 46%, and 43%, respectively. The main difference was between Grade 0/1 and Grade 2/3 extension, the latter having a lower 5-year local control rate (86% in Grade 0/1 vs. 72% in Grade 2/3: P < 0.0001) and distant metastasis free survival rate (87% in Grade 0/1 vs. 68% in Grade 2/3; P = 0.0002). Multivariate analysis showed that Grade 2/3 paranasopharyngeal extension was an independent factor in predicting overall relapse, local relapse, and distant metastasis. Advanced T classification (T3) was another independent factor in predicting overall and local relapse, whereas advanced N classification (N3) was another independent factor in predicting overall relapse and distant metastasis. CONCLUSIONS. Extensive paranasopharyngeal extension (Grade 2/3) was an independent prognostic factor associated with poorer treatment outcome, both in local control and distant metastasis. Ho's T2 disease should be further subclassified into T2a and T2b, which include Grade 0/1 and Grade 2/3 paranasopharyngeal disease, respectively.
Persistent Identifierhttp://hdl.handle.net/10722/150719
ISSN
2015 Impact Factor: 5.649
2015 SCImago Journal Rankings: 3.188
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChua, DTTen_HK
dc.contributor.authorSham, JSTen_HK
dc.contributor.authorKwong, DLWen_HK
dc.contributor.authorChoy, DTKen_HK
dc.contributor.authorAu, GKHen_HK
dc.contributor.authorWu, PMen_HK
dc.date.accessioned2012-06-26T06:09:11Z-
dc.date.available2012-06-26T06:09:11Z-
dc.date.issued1996en_HK
dc.identifier.citationCancer, 1996, v. 78 n. 2, p. 202-210en_HK
dc.identifier.issn0008-543Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/150719-
dc.description.abstractBACKGROUND. This study was conducted to evaluate the prognostic value of paranasopharyngeal extension in local control and distant metastasis in patients with nasopharyngeal carcinoma. METHODS. Three hundred and sixty- four patients with newly diagnosed nasopharyngeal carcinoma without distant metastasis were reviewed. Patients were staged according to Ho's staging system. Using a semiquantitative method, tumor extension into the paranasopharyngeal space was graded as: 0: no extension; 1:-extension to the retrostyloid space; 2:-extension to the prestyloid space; and 3:-extension to the anterior part of the masticator space. All patients received radiotherapy as primary treatment. Median follow-up time was 45 months (range, 4.7 to 76.5 months). Relapse free, local relapse free, and distant metastasis free survival were estimated using the Kaplan-Meier method. Cox regression was also performed to adjust for prognostic factors. RESULTS. The incidence of paranasopharyngeal extension was high (72.5%). Of these patients, 65.5% had Grade 2 or 3 extension. The 5-year relapse free survival rates for Grade 0, 1, 2, and 3 extension were 76%, 70%, 46%, and 43%, respectively. The main difference was between Grade 0/1 and Grade 2/3 extension, the latter having a lower 5-year local control rate (86% in Grade 0/1 vs. 72% in Grade 2/3: P < 0.0001) and distant metastasis free survival rate (87% in Grade 0/1 vs. 68% in Grade 2/3; P = 0.0002). Multivariate analysis showed that Grade 2/3 paranasopharyngeal extension was an independent factor in predicting overall relapse, local relapse, and distant metastasis. Advanced T classification (T3) was another independent factor in predicting overall and local relapse, whereas advanced N classification (N3) was another independent factor in predicting overall relapse and distant metastasis. CONCLUSIONS. Extensive paranasopharyngeal extension (Grade 2/3) was an independent prognostic factor associated with poorer treatment outcome, both in local control and distant metastasis. Ho's T2 disease should be further subclassified into T2a and T2b, which include Grade 0/1 and Grade 2/3 paranasopharyngeal disease, respectively.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741en_HK
dc.relation.ispartofCanceren_HK
dc.subjectdistant metastasisen_HK
dc.subjectlocal controlen_HK
dc.subjectnasopharyngeal carcinomaen_HK
dc.subjectparanasopharyngeal extensionen_HK
dc.subjectprognostic factoren_HK
dc.subject.meshAdulten_US
dc.subject.meshCarcinoma - Pathology - Radiotherapy - Secondaryen_US
dc.subject.meshDisease-Free Survivalen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshForecastingen_US
dc.subject.meshHead And Neck Neoplasms - Pathologyen_US
dc.subject.meshHumansen_US
dc.subject.meshLymphatic Metastasis - Pathologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMultivariate Analysisen_US
dc.subject.meshNasopharyngeal Neoplasms - Pathology - Radiotherapyen_US
dc.subject.meshNasopharynx - Pathologyen_US
dc.subject.meshNeck - Pathologyen_US
dc.subject.meshNeoplasm Invasivenessen_US
dc.subject.meshNeoplasm Recurrence, Local - Pathologyen_US
dc.subject.meshNeoplasm Stagingen_US
dc.subject.meshPrognosisen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshTreatment Outcomeen_US
dc.titlePrognostic value of paranasopharyngeal extension of nasopharyngeal carcinoma: A significant factor in local control and distant metastasisen_HK
dc.typeArticleen_HK
dc.identifier.emailChua, DTT: dttchua@hkucc.hku.hken_HK
dc.identifier.emailKwong, DLW: dlwkwong@hku.hken_HK
dc.identifier.authorityChua, DTT=rp00415en_HK
dc.identifier.authorityKwong, DLW=rp00414en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1002/(SICI)1097-0142(19960715)78:2<202::AID-CNCR3>3.0.CO;2-Nen_HK
dc.identifier.pmid8673993-
dc.identifier.scopuseid_2-s2.0-0029681549en_HK
dc.identifier.hkuros27654-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0029681549&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume78en_HK
dc.identifier.issue2en_HK
dc.identifier.spage202en_HK
dc.identifier.epage210en_HK
dc.identifier.isiWOS:A1996UV02200003-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChua, DTT=7006773480en_HK
dc.identifier.scopusauthoridSham, JST=7101655565en_HK
dc.identifier.scopusauthoridKwong, DLW=15744231600en_HK
dc.identifier.scopusauthoridChoy, DTK=7102939127en_HK
dc.identifier.scopusauthoridAu, GKH=7003748615en_HK
dc.identifier.scopusauthoridWu, PM=8663653900en_HK

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