Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fu-ma Road, Fuzhou, 350014, China.
Fujian Medical University, Fuzhou, China.
Eur Arch Otorhinolaryngol. 2021 Dec;278(12):4955-4965. doi: 10.1007/s00405-021-06730-8. Epub 2021 Mar 14.
Previous studies have shown that approximately 10% of nasopharyngeal cancer (NPC) patients die within a year of disease onset, and that age is an independent predictor. However, no predictive model has been developed. We aimed to establish novel prognostic models to predict the 1-year cancer-specific survival (CSS) of young, middle-aged, and older patients with NPC after radiotherapy.
The data of 2822 NPC patients who underwent radiotherapy between 2004 and 2015 were reviewed from the surveillance, epidemiology, and end results database. We divided them into young, middle-aged, and older people groups according to age (< 44 years, 45-59 years, and ≥ 60 years, respectively). Multivariate analyses were performed, and prognostic models were constructed.
Multivariate analyses indicated that age, ethnicity, histological subtype, T, and M stage were independent predictors of 1-year CSS in the older people group. In contrast, ethnicity and age were not found to have predictive value in the young and middle-aged groups, respectively. Accordingly, three prognostic models with excellent predictive values were established for the three groups (C-indices: 0.791 [95% CI 0.722-0.859], 0.763 [95% CI 0.721-0.806] and 0.723 [95% CI 0.683-0.763], respectively). These predictive values are higher than those of the eighth edition American joint committee cancer tumor-node-metastasis (TNM) classification system.
Three prognostic models for predicting the 1-year CSS of young, middle-aged, and older NPC patients after radiotherapy showed better predictive power than the TNM classification system. These models may guide treatment strategies and clinical decision-making in different cohorts.
先前的研究表明，约有 10%的鼻咽癌（NPC）患者在发病后一年内死亡，且年龄是一个独立的预测因素。然而，目前尚未建立预测模型。我们旨在建立新的预后模型，以预测接受放疗后年轻、中年和老年 NPC 患者的 1 年癌症特异性生存率（CSS）。
回顾了 2004 年至 2015 年间在监测、流行病学和最终结果数据库中接受放疗的 2822 例 NPC 患者的数据。我们根据年龄（<44 岁、45-59 岁和≥60 岁）将他们分为年轻、中年和老年组。进行多变量分析，并构建预后模型。
多变量分析表明，年龄、种族、组织学亚型、T 和 M 分期是老年组 1 年 CSS 的独立预测因素。相比之下，种族和年龄在年轻和中年组中没有预测价值。因此，为三组分别建立了三个具有优异预测值的预后模型（C 指数：0.791[95%CI 0.722-0.859]、0.763[95%CI 0.721-0.806]和 0.723[95%CI 0.683-0.763]）。这些预测值高于第八版美国联合癌症肿瘤-淋巴结-转移（TNM）分期系统。
三种用于预测接受放疗的年轻、中年和老年 NPC 患者 1 年 CSS 的预后模型显示出比 TNM 分期系统更好的预测能力。这些模型可能为不同队列的治疗策略和临床决策提供指导。
