Title |
Subdivision of M category for nasopharyngeal carcinoma with synchronous metastasis: time to expand the M categorization system
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Published in |
Cancer Communications, August 2015
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DOI | 10.1186/s40880-015-0031-9 |
Pubmed ID | |
Authors |
Lu-Jun Shen, Si-Yang Wang, Guo-Feng Xie, Qi Zeng, Chen Chen, An-Nan Dong, Zhi-Mei Huang, Chang-Chuan Pan, Yun-Fei Xia, Pei-Hong Wu |
Abstract |
The current metastatic category (M) of nasopharyngeal carcinoma (NPC) is a "catch-all" classification, covering a heterogeneous group of tumors ranging from potentially curable to incurable. The aim of this study was to design an M categorization system that could be applied in planning the treatment of NPC with synchronous metastasis. A total of 505 NPC patients diagnosed with synchronous metastasis at Sun Yat-sen University Cancer Center between 2000 and 2009 were involved. The associations of clinical variables, metastatic features, and a proposed M categorization system with overall survival (OS) were determined by using Cox regression model. Multivariate analysis showed that Union for International Cancer Control (UICC) N category (N1-3/N0), number of metastatic lesions (multiple/single), liver involvement (yes/no), radiotherapy to primary tumor (yes/no), and cycles of chemotherapy (>4/≤4) were independent prognostic factors for OS. We defined the following subcategories based on liver involvement and the number of metastatic lesions: M1a, single lesion confined to an isolated organ or location except the liver; M1b, single lesion in the liver and/or multiple lesions in any organs or locations except the liver; and M1c, multiple lesions in the liver. Of the 505 cases, 74 (14.7%) were classified as M1a, 296 (58.6%) as M1b, 134 (26.5%) as M1c, and 1 was not specified. The three M1 subcategories showed significant difference in OS [M1b vs. M1a, hazard ratio (HR) = 1.69, 95% confidence interval (CI) = 1.16-2.48, P = 0.007; M1c vs. M1a, HR = 2.64, 95% CI = 1.75-3.98, P < 0.001]. We developed an M categorization system based on the independent factors related to the prognosis of patients with metastatic NPC. This system may be helpful to further optimize individualized care for NPC patients. |
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Country | Count | As % |
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Demographic breakdown
Readers by professional status | Count | As % |
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Student > Bachelor | 2 | 14% |
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Student > Master | 1 | 7% |
Other | 2 | 14% |
Unknown | 5 | 36% |
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Neuroscience | 1 | 7% |
Other | 0 | 0% |
Unknown | 5 | 36% |