Gille Evelina, Näsman Anders, Helmersson Madeleine, Marsk Elin, Mäkitie Antti, Hammarstedt-Nordenvall Lalle
Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska Hospital, Stockholm, Sweden.
Department of Oncology-Pathology, Karolinska Institute, Bioclinicum, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Pathology, Karolinska University Hospital, Stockholm, Sweden.
Acta Oncol. 2025 Jul 21;64:894-901. doi: 10.2340/1651-226X.2025.43700.
The purpose of this study is to present the nationwide disease burden and survival of nasopharyngeal carcinoma (NPC) in Sweden. The subcohort from the Stockholm-Gotland region was included to investigate the prevalence of Epstein-Barr virus (EBV) in NPC and to describe pattern of relapse.
This population-based nationwide study included patients diagnosed with NPC in Sweden during 2008-2021. The series was retrieved from the Swedish Head and Neck Cancer Register. Age at diagnosis, sex, tumor histopathology, stage, treatment intent, treatment, radiation dose, follow-up time, time to relapse, and site of relapse were recorded. The Stockholm-Gotland region series was used to obtain an updated histopathological analysis including EBV status and to analyze site of relapse.
The nationwide study cohort comprised 399 patients, 33% were female. Mean age at diagnosis did not differ between the sexes: 56.3 years for females, 57.5 years for males. Seventy-one percent presented with Stage III or IV. The 5-year overall survival (OS) was 73.2%. In the regional cohort, 73.9% were EBV positive. In the competing risk analysis, the cumulative incidence of distant metastatic relapse was higher than that of local and/or regional relapse at 5 years (18.7% vs. 12.4%). However, the confidence intervals were wide, and the difference should be interpreted with caution.
The survival outcome in our study seems comparable to previous studies in nonendemic countries. There was a high percentage of EBV-positive tumors compared with the previous studies in nonendemic countries.
本研究的目的是呈现瑞典全国范围内鼻咽癌（NPC）的疾病负担和生存率。纳入了斯德哥尔摩 - 哥特兰地区的亚队列，以调查NPC中爱泼斯坦 - 巴尔病毒（EBV）的流行情况并描述复发模式。
这项基于人群的全国性研究纳入了2008年至2021年期间在瑞典被诊断为NPC的患者。该系列数据从瑞典头颈癌登记处获取。记录了诊断时的年龄、性别、肿瘤组织病理学、分期、治疗意图、治疗、放射剂量、随访时间、复发时间和复发部位。使用斯德哥尔摩 - 哥特兰地区系列数据进行更新的组织病理学分析，包括EBV状态，并分析复发部位。
全国性研究队列包括399名患者，33%为女性。诊断时的平均年龄在性别之间无差异：女性为56.3岁，男性为57.5岁。71%的患者表现为III期或IV期。5年总生存率（OS）为73.2%。在地区队列中，73.9%为EBV阳性。在竞争风险分析中，5年时远处转移复发的累积发生率高于局部和/或区域复发（18.7%对12.4%）。然而，置信区间较宽，应谨慎解释这种差异。
我们研究中的生存结果似乎与非流行国家以前的研究相当。与非流行国家以前的研究相比，EBV阳性肿瘤的比例较高。
