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Oligometastases in AJCC stage IVc nasopharyngeal carcinoma: A subset with better overall survival
Author(s) -
Tian Yunhong,
Zou Wenhui,
Xiao Weiwei,
Zeng Lei,
Yuan Xia,
Bai Li,
Lu Taixiang,
Tian Yunming,
Han Fei
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24345
Subject(s) - medicine , nasopharyngeal carcinoma , radiation therapy , oncology , metastasis , stage (stratigraphy) , cancer , chemotherapy , primary tumor , carcinoma , incidence (geometry) , radiology , paleontology , physics , optics , biology
Background The purpose of this study was to analyze the patterns of metastasis and therapeutic approaches in American Joint Committee on Cancer (AJCC) stage IVc nasopharyngeal carcinoma (NPC). Methods A retrospective analysis of 263 patients with stage IVc NPC revealed the incidence of bone, liver, and lung metastases was 67.7%, 32.3%, and 16.0%, respectively. All patients received chemotherapy; 160 patients received radiotherapy (RT) to the primary tumor. Results The factors associated with poor overall survival (OS) were Karnofsky Performance Scale (KPS) ≤70, liver metastasis, multiple‐organ metastasis, ≥6 lesions, no RT to the primary tumor, and <4 chemotherapy cycles. Two subgroups of M1 disease were divided into: M1a (oligometastases) = single‐organ metastases or 1 to 5 lesions; and M1b = multiple‐organ metastases or ≥6 lesions. The 5‐year OS rates for M1a and M1b were 38.7% versus 7.0%, respectively. Conclusion Patients with oligometastases have significantly better OS than patients with widespread metastases. Long‐term disease‐free survival can be achieved in selected patients with oligometastases after systemic chemotherapy and definitive RT. © 2016 Wiley Periodicals, Inc. Head Neck 38:1152–1157, 2016