Yin Xue, Lv Lu, Pan Xin-Bin
Department of Oncology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, China.
Front Oncol. 2020 Sep 25;10:523956. doi: 10.3389/fonc.2020.523956. eCollection 2020.
This study aims to identify the prognosis of the extracapsular spread (ECS) of cervical lymph node metastases in nasopharyngeal carcinoma (NPC).
Patients with NPC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2016. Pathologically confirmed World Health Patients with World Health Organization types I, II, and III NPC with complete ECS data of cervical lymph node metastases were investigated. The included patients were divided into non-ECS and ECS groups. The 10-year overall survival (OS) and cancer-specific survival (CSS) were compared between the two groups using the Kaplan-Meier method and propensity score matching analyses.
A total of 625 patients were included. The ECS group included 99 (15.84%) patients. The non-ECS group included 526 (84.16%) patients. The 10-year OS (50.2 vs. 35.8%; < 0.001) and CSS (64.8 vs. 45.7%; < 0.001) were better in the non-ECS group than in the ECS group in the unmatched cohort. Propensity score matching analyses revealed favorable 10-year OS (52.7 vs. 35.8%; = 0.008) and CSS (61.2 vs. 45.7%; = 0.008) in the non-ECS group with respect to the ECS group. Age, sex, race, AJCC stage, and ECS (hazard ratio (HR) = 1.71, 95% confidence interval (CI), 1.14-2.57, = 0.010) were independent prognostic factors for OS. Age, sex, AJCC stage, and ECS (HR = 1.91; 95% CI, 1.21-3.01; = 0.005) were independent prognostic factors for CSS.
This study indicated that ECS is a prognostic risk factor for NPC. Further studies should be performed to verify the results due to the limitations of the SEER database.
本研究旨在确定鼻咽癌（NPC）颈部淋巴结转移的包膜外扩散（ECS）的预后情况。
从2004年至2016年的监测、流行病学和最终结果（SEER）数据库中提取NPC患者。对经病理证实的世界卫生组织I、II和III型NPC且有颈部淋巴结转移完整ECS数据的患者进行研究。将纳入的患者分为非ECS组和ECS组。采用Kaplan-Meier法和倾向评分匹配分析比较两组的10年总生存率（OS）和癌症特异性生存率（CSS）。
共纳入625例患者。ECS组包括99例（15.84%）患者。非ECS组包括526例（84.16%）患者。在未匹配队列中，非ECS组的10年OS（50.2%对35.8%；<0.001）和CSS（64.8%对45.7%；<0.001）优于ECS组。倾向评分匹配分析显示，非ECS组相对于ECS组的10年OS（52.7%对35.8%；=0.008）和CSS（61.2%对45.7%；=0.008）较好。年龄、性别、种族、美国癌症联合委员会（AJCC）分期和ECS（风险比（HR）=1.71，95%置信区间（CI），1.14 - 2.57，=0.010）是OS的独立预后因素。年龄、性别 、AJCC分期和ECS（HR = 1.91；95% CI，1.21 - 3.01；=0.005）是CSS的独立预后因素。
本研究表明ECS是NPC的预后危险因素。由于SEER数据库的局限性，应进行进一步研究以验证结果。
