Prognostic value of paranasopharyngeal extension of nasopharyngeal carcinoma: A significant factor in local control and distant metastasis
BACKGROUND This study was conducted to evaluate the prognostic value of paranasopharyngeal extension in local control and distant metastasis in patients with nasopharyngeal carcinoma. METHODS Three hundred and sixty‐four patients with newly diagnosed nasopharyngeal carcinoma without distant metastas...
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| Veröffentlicht in: | Cancer 1996-07, Vol.78 (2), p.202-210 |
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| creator | Chua, Daniel T. T. Sham, Jonathan S. T. Kwong, Dora L. W. Choy, Damon T. K. Au, Gordon K. H. Wu, P. M. |
| description | BACKGROUND
This study was conducted to evaluate the prognostic value of paranasopharyngeal extension in local control and distant metastasis in patients with nasopharyngeal carcinoma.
METHODS
Three hundred and sixty‐four patients with newly diagnosed nasopharyngeal carcinoma without distant metastasis were reviewed. Patients were staged according to Ho's staging system. Using a semiquantitative method, tumor extension into the paranasopharyngeal space was graded as: 0: no extension; 1:‐extension to the retrostyloid space; 2:‐extension to the prestyloid space; and 3:‐extension to the anterior part of the masticator space. All patients received radiotherapy as primary treatment. Median follow‐up time was 45 months (range, 4.7 to 76.5 months). Relapse free, local relapse free, and distant metastasis free survival were estimated using the Kaplan‐Meier method. Cox regression was also performed to adjust for prognostic factors.
RESULTS
The incidence of paranasopharyngeal extension was high (72.5%). Of these patients, 65.5% had Grade 2 or 3 extension. The 5‐year relapse free survival rates for Grade 0, 1, 2, and 3 extension were 76%, 70%, 46%, and 43%, respectively. The main difference was between Grade 0/1 and Grade 2/3 extension, the latter having a lower 5‐year local control rate (86% in Grade 0/1 vs. 72% in Grade 2/3; P < 0.0001) and distant metastasis free survival rate (87% in Grade 0/1 vs. 68% in Grade 2/3; P = 0.0002). Multivariate analysis showed that Grade 2/3 paranasopharyngeal extension was an independent factor in predicting overall relapse, local relapse, and distant metastasis. Advanced T classification (T3) was another independent factor in predicting overall and local relapse, whereas advanced N classification (N3) was another independent factor in predicting overall relapse and distant metastasis.
CONCLUSIONS
Extensive paranasopharyngeal extension (Grade 2/3) was an independent prognostic factor associated with poorer treatment outcome, both in local control and distant metastasis. Ho's T2 disease should be further subclassified into T2a and T2b, which include Grade 0/1 and Grade 2/3 paranasopharyngeal disease, respectively. Cancer 1996; 78:202‐10. |
| doi_str_mv | 10.1002/(SICI)1097-0142(19960715)78:2<202::AID-CNCR3>3.0.CO;2-N |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_78149406</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>78149406</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4753-cd1fb861ffbeb6cb963e48d049381a61991d029201d3dd0a3d4c88546ba2daa43</originalsourceid><addsrcrecordid>eNqFkcmOEzEYhFsINGQGHgHJB4RmDh289eKAQFGzRRoliEXMzfrbdgejjh3szsC8Ak-Nm4QcAImTl_r8q1yVZc8JnhKM6ePz94tmcUGwqHJMOD0nQpS4IsVFVc_oU4rpbDZfvMibZfOOPWNTPG1WT2i-vJVNjm9uZxOMcZ0XnF3dzU5j_JKOFS3YSXZSlxUTgk2yH2-DXzsfB6vQNfQ7g3yHthDAQfTbzxBu3NpAj8z3wbhovRv1PzQFQVnnNzBDcxTt2tnOKnAD6kANPiDrUO_VCHo3BN8jcBppG4eR2ZgB0i7aeC-700Efzf3DepZ9fPXyQ_Mmv1y9XjTzy1zxqmC50qRr65J0XWvaUrWiZIbXGnPBagJlCopoTAXFRDOtMTDNVV0XvGyBagDOzrJH-7nb4L_uTBzkxkZl-h6c8bsoq5pwwXGZwE97UAUfYzCd3Aa7Sd-WBMuxJSnHluSYuBwTl79bSjMklXQkUkvyV0uSSSybVbpfpskPDhZ27cbo49xDLUl_eNAhpuC6VIey8YgxQgUucMKu9tg325ubv9z919y_vO0v2E_acr4w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>78149406</pqid></control><display><type>article</type><title>Prognostic value of paranasopharyngeal extension of nasopharyngeal carcinoma: A significant factor in local control and distant metastasis</title><source>MEDLINE</source><source>Wiley Journals</source><source>Wiley Online Library (Open Access Collection)</source><source>Alma/SFX Local Collection</source><creator>Chua, Daniel T. T. ; Sham, Jonathan S. T. ; Kwong, Dora L. W. ; Choy, Damon T. K. ; Au, Gordon K. H. ; Wu, P. M.</creator><creatorcontrib>Chua, Daniel T. T. ; Sham, Jonathan S. T. ; Kwong, Dora L. W. ; Choy, Damon T. K. ; Au, Gordon K. H. ; Wu, P. M.</creatorcontrib><description>BACKGROUND
This study was conducted to evaluate the prognostic value of paranasopharyngeal extension in local control and distant metastasis in patients with nasopharyngeal carcinoma.
METHODS
Three hundred and sixty‐four patients with newly diagnosed nasopharyngeal carcinoma without distant metastasis were reviewed. Patients were staged according to Ho's staging system. Using a semiquantitative method, tumor extension into the paranasopharyngeal space was graded as: 0: no extension; 1:‐extension to the retrostyloid space; 2:‐extension to the prestyloid space; and 3:‐extension to the anterior part of the masticator space. All patients received radiotherapy as primary treatment. Median follow‐up time was 45 months (range, 4.7 to 76.5 months). Relapse free, local relapse free, and distant metastasis free survival were estimated using the Kaplan‐Meier method. Cox regression was also performed to adjust for prognostic factors.
RESULTS
The incidence of paranasopharyngeal extension was high (72.5%). Of these patients, 65.5% had Grade 2 or 3 extension. The 5‐year relapse free survival rates for Grade 0, 1, 2, and 3 extension were 76%, 70%, 46%, and 43%, respectively. The main difference was between Grade 0/1 and Grade 2/3 extension, the latter having a lower 5‐year local control rate (86% in Grade 0/1 vs. 72% in Grade 2/3; P < 0.0001) and distant metastasis free survival rate (87% in Grade 0/1 vs. 68% in Grade 2/3; P = 0.0002). Multivariate analysis showed that Grade 2/3 paranasopharyngeal extension was an independent factor in predicting overall relapse, local relapse, and distant metastasis. Advanced T classification (T3) was another independent factor in predicting overall and local relapse, whereas advanced N classification (N3) was another independent factor in predicting overall relapse and distant metastasis.
CONCLUSIONS
Extensive paranasopharyngeal extension (Grade 2/3) was an independent prognostic factor associated with poorer treatment outcome, both in local control and distant metastasis. Ho's T2 disease should be further subclassified into T2a and T2b, which include Grade 0/1 and Grade 2/3 paranasopharyngeal disease, respectively. Cancer 1996; 78:202‐10.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/(SICI)1097-0142(19960715)78:2<202::AID-CNCR3>3.0.CO;2-N</identifier><identifier>PMID: 8673993</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>New York: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adult ; Biological and medical sciences ; Carcinoma - pathology ; Carcinoma - radiotherapy ; Carcinoma - secondary ; Disease-Free Survival ; distant metastasis ; Female ; Follow-Up Studies ; Forecasting ; Head and Neck Neoplasms - pathology ; Humans ; local control ; Lymphatic Metastasis - pathology ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; nasopharyngeal carcinoma ; Nasopharyngeal Neoplasms - pathology ; Nasopharyngeal Neoplasms - radiotherapy ; Nasopharynx - pathology ; Neck - pathology ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local - pathology ; Neoplasm Staging ; Otorhinolaryngology. Stomatology ; paranasopharyngeal extension ; Prognosis ; prognostic factor ; Prospective Studies ; Treatment Outcome ; Tumors ; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</subject><ispartof>Cancer, 1996-07, Vol.78 (2), p.202-210</ispartof><rights>Copyright © 1996 American Cancer Society</rights><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4753-cd1fb861ffbeb6cb963e48d049381a61991d029201d3dd0a3d4c88546ba2daa43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2F%28SICI%291097-0142%2819960715%2978%3A2%3C202%3A%3AAID-CNCR3%3E3.0.CO%3B2-N$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2F%28SICI%291097-0142%2819960715%2978%3A2%3C202%3A%3AAID-CNCR3%3E3.0.CO%3B2-N$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3129050$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8673993$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chua, Daniel T. T.</creatorcontrib><creatorcontrib>Sham, Jonathan S. T.</creatorcontrib><creatorcontrib>Kwong, Dora L. W.</creatorcontrib><creatorcontrib>Choy, Damon T. K.</creatorcontrib><creatorcontrib>Au, Gordon K. H.</creatorcontrib><creatorcontrib>Wu, P. M.</creatorcontrib><title>Prognostic value of paranasopharyngeal extension of nasopharyngeal carcinoma: A significant factor in local control and distant metastasis</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND
This study was conducted to evaluate the prognostic value of paranasopharyngeal extension in local control and distant metastasis in patients with nasopharyngeal carcinoma.
METHODS
Three hundred and sixty‐four patients with newly diagnosed nasopharyngeal carcinoma without distant metastasis were reviewed. Patients were staged according to Ho's staging system. Using a semiquantitative method, tumor extension into the paranasopharyngeal space was graded as: 0: no extension; 1:‐extension to the retrostyloid space; 2:‐extension to the prestyloid space; and 3:‐extension to the anterior part of the masticator space. All patients received radiotherapy as primary treatment. Median follow‐up time was 45 months (range, 4.7 to 76.5 months). Relapse free, local relapse free, and distant metastasis free survival were estimated using the Kaplan‐Meier method. Cox regression was also performed to adjust for prognostic factors.
RESULTS
The incidence of paranasopharyngeal extension was high (72.5%). Of these patients, 65.5% had Grade 2 or 3 extension. The 5‐year relapse free survival rates for Grade 0, 1, 2, and 3 extension were 76%, 70%, 46%, and 43%, respectively. The main difference was between Grade 0/1 and Grade 2/3 extension, the latter having a lower 5‐year local control rate (86% in Grade 0/1 vs. 72% in Grade 2/3; P < 0.0001) and distant metastasis free survival rate (87% in Grade 0/1 vs. 68% in Grade 2/3; P = 0.0002). Multivariate analysis showed that Grade 2/3 paranasopharyngeal extension was an independent factor in predicting overall relapse, local relapse, and distant metastasis. Advanced T classification (T3) was another independent factor in predicting overall and local relapse, whereas advanced N classification (N3) was another independent factor in predicting overall relapse and distant metastasis.
CONCLUSIONS
Extensive paranasopharyngeal extension (Grade 2/3) was an independent prognostic factor associated with poorer treatment outcome, both in local control and distant metastasis. Ho's T2 disease should be further subclassified into T2a and T2b, which include Grade 0/1 and Grade 2/3 paranasopharyngeal disease, respectively. Cancer 1996; 78:202‐10.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Carcinoma - pathology</subject><subject>Carcinoma - radiotherapy</subject><subject>Carcinoma - secondary</subject><subject>Disease-Free Survival</subject><subject>distant metastasis</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Forecasting</subject><subject>Head and Neck Neoplasms - pathology</subject><subject>Humans</subject><subject>local control</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>nasopharyngeal carcinoma</subject><subject>Nasopharyngeal Neoplasms - pathology</subject><subject>Nasopharyngeal Neoplasms - radiotherapy</subject><subject>Nasopharynx - pathology</subject><subject>Neck - pathology</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Staging</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>paranasopharyngeal extension</subject><subject>Prognosis</subject><subject>prognostic factor</subject><subject>Prospective Studies</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcmOEzEYhFsINGQGHgHJB4RmDh289eKAQFGzRRoliEXMzfrbdgejjh3szsC8Ak-Nm4QcAImTl_r8q1yVZc8JnhKM6ePz94tmcUGwqHJMOD0nQpS4IsVFVc_oU4rpbDZfvMibZfOOPWNTPG1WT2i-vJVNjm9uZxOMcZ0XnF3dzU5j_JKOFS3YSXZSlxUTgk2yH2-DXzsfB6vQNfQ7g3yHthDAQfTbzxBu3NpAj8z3wbhovRv1PzQFQVnnNzBDcxTt2tnOKnAD6kANPiDrUO_VCHo3BN8jcBppG4eR2ZgB0i7aeC-700Efzf3DepZ9fPXyQ_Mmv1y9XjTzy1zxqmC50qRr65J0XWvaUrWiZIbXGnPBagJlCopoTAXFRDOtMTDNVV0XvGyBagDOzrJH-7nb4L_uTBzkxkZl-h6c8bsoq5pwwXGZwE97UAUfYzCd3Aa7Sd-WBMuxJSnHluSYuBwTl79bSjMklXQkUkvyV0uSSSybVbpfpskPDhZ27cbo49xDLUl_eNAhpuC6VIey8YgxQgUucMKu9tg325ubv9z919y_vO0v2E_acr4w</recordid><startdate>19960715</startdate><enddate>19960715</enddate><creator>Chua, Daniel T. T.</creator><creator>Sham, Jonathan S. T.</creator><creator>Kwong, Dora L. W.</creator><creator>Choy, Damon T. K.</creator><creator>Au, Gordon K. H.</creator><creator>Wu, P. M.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Liss</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19960715</creationdate><title>Prognostic value of paranasopharyngeal extension of nasopharyngeal carcinoma: A significant factor in local control and distant metastasis</title><author>Chua, Daniel T. T. ; Sham, Jonathan S. T. ; Kwong, Dora L. W. ; Choy, Damon T. K. ; Au, Gordon K. H. ; Wu, P. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4753-cd1fb861ffbeb6cb963e48d049381a61991d029201d3dd0a3d4c88546ba2daa43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Carcinoma - pathology</topic><topic>Carcinoma - radiotherapy</topic><topic>Carcinoma - secondary</topic><topic>Disease-Free Survival</topic><topic>distant metastasis</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Forecasting</topic><topic>Head and Neck Neoplasms - pathology</topic><topic>Humans</topic><topic>local control</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>nasopharyngeal carcinoma</topic><topic>Nasopharyngeal Neoplasms - pathology</topic><topic>Nasopharyngeal Neoplasms - radiotherapy</topic><topic>Nasopharynx - pathology</topic><topic>Neck - pathology</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Staging</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>paranasopharyngeal extension</topic><topic>Prognosis</topic><topic>prognostic factor</topic><topic>Prospective Studies</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chua, Daniel T. T.</creatorcontrib><creatorcontrib>Sham, Jonathan S. T.</creatorcontrib><creatorcontrib>Kwong, Dora L. W.</creatorcontrib><creatorcontrib>Choy, Damon T. K.</creatorcontrib><creatorcontrib>Au, Gordon K. H.</creatorcontrib><creatorcontrib>Wu, P. M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chua, Daniel T. T.</au><au>Sham, Jonathan S. T.</au><au>Kwong, Dora L. W.</au><au>Choy, Damon T. K.</au><au>Au, Gordon K. H.</au><au>Wu, P. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of paranasopharyngeal extension of nasopharyngeal carcinoma: A significant factor in local control and distant metastasis</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>1996-07-15</date><risdate>1996</risdate><volume>78</volume><issue>2</issue><spage>202</spage><epage>210</epage><pages>202-210</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND
This study was conducted to evaluate the prognostic value of paranasopharyngeal extension in local control and distant metastasis in patients with nasopharyngeal carcinoma.
METHODS
Three hundred and sixty‐four patients with newly diagnosed nasopharyngeal carcinoma without distant metastasis were reviewed. Patients were staged according to Ho's staging system. Using a semiquantitative method, tumor extension into the paranasopharyngeal space was graded as: 0: no extension; 1:‐extension to the retrostyloid space; 2:‐extension to the prestyloid space; and 3:‐extension to the anterior part of the masticator space. All patients received radiotherapy as primary treatment. Median follow‐up time was 45 months (range, 4.7 to 76.5 months). Relapse free, local relapse free, and distant metastasis free survival were estimated using the Kaplan‐Meier method. Cox regression was also performed to adjust for prognostic factors.
RESULTS
The incidence of paranasopharyngeal extension was high (72.5%). Of these patients, 65.5% had Grade 2 or 3 extension. The 5‐year relapse free survival rates for Grade 0, 1, 2, and 3 extension were 76%, 70%, 46%, and 43%, respectively. The main difference was between Grade 0/1 and Grade 2/3 extension, the latter having a lower 5‐year local control rate (86% in Grade 0/1 vs. 72% in Grade 2/3; P < 0.0001) and distant metastasis free survival rate (87% in Grade 0/1 vs. 68% in Grade 2/3; P = 0.0002). Multivariate analysis showed that Grade 2/3 paranasopharyngeal extension was an independent factor in predicting overall relapse, local relapse, and distant metastasis. Advanced T classification (T3) was another independent factor in predicting overall and local relapse, whereas advanced N classification (N3) was another independent factor in predicting overall relapse and distant metastasis.
CONCLUSIONS
Extensive paranasopharyngeal extension (Grade 2/3) was an independent prognostic factor associated with poorer treatment outcome, both in local control and distant metastasis. Ho's T2 disease should be further subclassified into T2a and T2b, which include Grade 0/1 and Grade 2/3 paranasopharyngeal disease, respectively. Cancer 1996; 78:202‐10.</abstract><cop>New York</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>8673993</pmid><doi>10.1002/(SICI)1097-0142(19960715)78:2<202::AID-CNCR3>3.0.CO;2-N</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Biological and medical sciences Carcinoma - pathology Carcinoma - radiotherapy Carcinoma - secondary Disease-Free Survival distant metastasis Female Follow-Up Studies Forecasting Head and Neck Neoplasms - pathology Humans local control Lymphatic Metastasis - pathology Male Medical sciences Middle Aged Multivariate Analysis nasopharyngeal carcinoma Nasopharyngeal Neoplasms - pathology Nasopharyngeal Neoplasms - radiotherapy Nasopharynx - pathology Neck - pathology Neoplasm Invasiveness Neoplasm Recurrence, Local - pathology Neoplasm Staging Otorhinolaryngology. Stomatology paranasopharyngeal extension Prognosis prognostic factor Prospective Studies Treatment Outcome Tumors Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology |
| title | Prognostic value of paranasopharyngeal extension of nasopharyngeal carcinoma: A significant factor in local control and distant metastasis |
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