Prognostic factors in metastatic nasopharyngeal carcinoma

Background. - The current retrospective study aimed to identify some determinants of survival in metastatic NPC. Methods. - The study concerned 95 patients with metastatic nasopharyngeal carcinoma treated between 1993 and 2001. Statistical comparison between patients subgroups survival was carried out employing the log-Rank test (statistical significance was defined as p <= 0.05). Multivariable analysis was performed using the Cox model (p <= 0.05 was used as the cut-off value of statistical significance). Factors that were considered included: age group(<= 45 years or > 45 years and <= 25 years or > 25 years), gender, performance status at diagnosis of metastatic disease (PS 0-1 or 2-3), time of metastasis diagnosis(at presentation or later), number of metastatic sites (single or multiple), specific metastatic sites(bone, liver, lung, distant nodes), number of bone metastasis(single or multiple),disease free survival(DFI) (<= or > 6 months), prior chemotherapy, radiotherapy of metastatic sites. Results. - Negative prognostic factors in univariate analysis were: poor PS (>= 1), multiple metastatic sites, multiple bone metastasis, previous chemotherapy, visceral or node metastasis and non irradiated metastasis. Poor PS, multiple metastatic sites, and prior chemotherapy were independently significant negative prognostic factors in multivariable analysis. Conclusions. - In this study we identified new prognostic factors in univariate and multivariate analysis.. A regular and careful follow-up of patients treated for NPC is then recommended in order to detect early metastatic dissemination (with minimal localizations) while patients have still a good PS. (C) 2007 Elsevier Masson SAS. All rights reserved.