Oligometastases in AJCC stage IVc nasopharyngeal carcinoma: A subset with better overall survival

Head Neck. 2016 Aug;38(8):1152-7. doi: 10.1002/hed.24345. Epub 2016 May 24.

Abstract

Background: The purpose of this study was to analyze the patterns of metastasis and therapeutic approaches in American Joint Committee on Cancer (AJCC) stage IVc nasopharyngeal carcinoma (NPC).

Methods: A retrospective analysis of 263 patients with stage IVc NPC revealed the incidence of bone, liver, and lung metastases was 67.7%, 32.3%, and 16.0%, respectively. All patients received chemotherapy; 160 patients received radiotherapy (RT) to the primary tumor.

Results: The factors associated with poor overall survival (OS) were Karnofsky Performance Scale (KPS) ≤70, liver metastasis, multiple-organ metastasis, ≥6 lesions, no RT to the primary tumor, and <4 chemotherapy cycles. Two subgroups of M1 disease were divided into: M1a (oligometastases) = single-organ metastases or 1 to 5 lesions; and M1b = multiple-organ metastases or ≥6 lesions. The 5-year OS rates for M1a and M1b were 38.7% versus 7.0%, respectively.

Conclusion: Patients with oligometastases have significantly better OS than patients with widespread metastases. Long-term disease-free survival can be achieved in selected patients with oligometastases after systemic chemotherapy and definitive RT. © 2016 Wiley Periodicals, Inc. Head Neck 38:1152-1157, 2016.

Keywords: chemotherapy; metastasis; nasopharyngeal carcinoma; prognostic model; radiotherapy.

MeSH terms

  • Advisory Committees
  • Analysis of Variance
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / mortality
  • Bone Neoplasms / secondary
  • Carcinoma / mortality*
  • Carcinoma / pathology*
  • Carcinoma / therapy
  • Cause of Death*
  • Chemoradiotherapy, Adjuvant
  • Cohort Studies
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Laryngectomy / methods
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary
  • Male
  • Multivariate Analysis
  • Nasopharyngeal Carcinoma
  • Nasopharyngeal Neoplasms / mortality*
  • Nasopharyngeal Neoplasms / pathology*
  • Nasopharyngeal Neoplasms / therapy
  • Neoplasm Invasiveness / pathology
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Time Factors
  • United States