Please use this identifier to cite or link to this item: https://doi.org/10.1186/s40880-016-0103-5
Title: A new prognostic histopathologic classification of nasopharyngeal carcinoma
Authors: Wang, H.-Y
Chang, Y.-L
To, K.-F
Hwang, J.S 
Mai, H.-Q
Keywords: adult
aged
chemoradiotherapy
child
female
human
male
middle aged
Nasopharyngeal Neoplasms
pathology
prognosis
proportional hazards model
prospective study
retrospective study
survival rate
very elderly
young adult
Adult
Aged
Aged, 80 and over
Chemoradiotherapy
Child
Female
Humans
Male
Middle Aged
Nasopharyngeal Neoplasms
Prognosis
Proportional Hazards Models
Prospective Studies
Retrospective Studies
Survival Rate
Young Adult
Issue Date: 2016
Citation: Wang, H.-Y, Chang, Y.-L, To, K.-F, Hwang, J.S, Mai, H.-Q (2016). A new prognostic histopathologic classification of nasopharyngeal carcinoma. Chinese journal of cancer 35 : 41. ScholarBank@NUS Repository. https://doi.org/10.1186/s40880-016-0103-5
Rights: Attribution 4.0 International
Abstract: BACKGROUND: The current World Health Organization (WHO) classification of nasopharyngeal carcinoma (NPC) conveys little prognostic information. This study aimed to propose an NPC histopathologic classification that can potentially be used to predict prognosis and treatment response.METHODS: We initially developed a histopathologic classification based on the morphologic traits and cell differentiation of tumors of 2716 NPC patients who were identified at Sun Yat-sen University Cancer Center (SYSUCC) (training cohort). Then, the proposed classification was applied to 1702 patients (retrospective validation cohort) from hospitals outside SYSUCC and 1613 patients (prospective validation cohort) from SYSUCC. The efficacy of radiochemotherapy and radiotherapy modalities was compared between the proposed subtypes. We used Cox proportional hazards models to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for overall survival (OS).RESULTS: The 5-year OS rates for all NPC patients who were diagnosed with epithelial carcinoma (EC; 3708 patients), mixed sarcomatoid-epithelial carcinoma (MSEC; 1247 patients), sarcomatoid carcinoma (SC; 823 patients), and squamous cell carcinoma (SCC; 253 patients) were 79.4%, 70.5%, 59.6%, and 42.6%, respectively (P < 0.001). In multivariate models, patients with MSEC had a shorter OS than patients with EC (HR = 1.44, 95% CI = 1.27-1.62), SC (HR = 2.00, 95% CI = 1.76-2.28), or SCC (HR = 4.23, 95% CI = 3.34-5.38). Radiochemotherapy significantly improved survival compared with radiotherapy alone for patients with EC (HR = 0.67, 95% CI = 0.56-0.80), MSEC (HR = 0.58, 95% CI = 0.49-0.75), and possibly for those with SCC (HR = 0.63; 95% CI = 0.40-0.98), but not for patients with SC (HR = 0.97, 95% CI = 0.74-1.28).CONCLUSIONS: The proposed classification offers more information for the prediction of NPC prognosis compared with the WHO classification and might be a valuable tool to guide treatment decisions for subtypes that are associated with a poor prognosis.
Source Title: Chinese journal of cancer
URI: https://scholarbank.nus.edu.sg/handle/10635/183335
ISSN: 1944446X
DOI: 10.1186/s40880-016-0103-5
Rights: Attribution 4.0 International
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