Please use this identifier to cite or link to this item: https://doi.org/10.1186/s40880-016-0103-5
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dc.titleA new prognostic histopathologic classification of nasopharyngeal carcinoma
dc.contributor.authorWang, H.-Y
dc.contributor.authorChang, Y.-L
dc.contributor.authorTo, K.-F
dc.contributor.authorHwang, J.S
dc.contributor.authorMai, H.-Q
dc.date.accessioned2020-11-10T07:57:35Z
dc.date.available2020-11-10T07:57:35Z
dc.date.issued2016
dc.identifier.citationWang, 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
dc.identifier.issn1944446X
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/183335
dc.description.abstractBACKGROUND: 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.
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceUnpaywall 20201031
dc.subjectadult
dc.subjectaged
dc.subjectchemoradiotherapy
dc.subjectchild
dc.subjectfemale
dc.subjecthuman
dc.subjectmale
dc.subjectmiddle aged
dc.subjectNasopharyngeal Neoplasms
dc.subjectpathology
dc.subjectprognosis
dc.subjectproportional hazards model
dc.subjectprospective study
dc.subjectretrospective study
dc.subjectsurvival rate
dc.subjectvery elderly
dc.subjectyoung adult
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectChemoradiotherapy
dc.subjectChild
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNasopharyngeal Neoplasms
dc.subjectPrognosis
dc.subjectProportional Hazards Models
dc.subjectProspective Studies
dc.subjectRetrospective Studies
dc.subjectSurvival Rate
dc.subjectYoung Adult
dc.typeArticle
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.description.doi10.1186/s40880-016-0103-5
dc.description.sourcetitleChinese journal of cancer
dc.description.volume35
dc.description.page41
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