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Treatment and outcomes of nasopharyngeal carcinoma in a unique non-endemic population.

Abstract：

OBJECTIVE:Nasopharyngeal carcinoma (NPC) is common in Southeast Asia. Due to the influx of immigrants from this region, the incidence in British Columbia is increasing. Current literature from non-endemic populations encompasses heterogeneous cohorts. This study examines NPC in a North American population, with a high incidence, to understand the population's characteristics, treatment outcomes and recurrence patterns. METHODS AND MATERIALS:A retrospective analysis of patients treated for primary and recurrent NPC over 15-years. Regression analyses were used to identify predictors of disease recurrence and death. A subgroup analysis of the locoregional recurrence cohort was conducted. Five-year survival outcomes were determined. RESULTS:601 patients were included. Asian ethnicity comprised 77% and the majority had non-keratinizing carcinoma (81%). In total, 19.3% of patients experienced recurrence: 58% local, 22% regional and 20% distant. Five-year overall survival was 70%. Smoking, advancing T-stage, poorer performance status and advanced overall stage were all associated with worse overall survival (p < 0.05). Asian ethnicity improved overall survival but not recurrence free survival. Similar features in addition to non-keratinizing histology were associated with increased locoregional recurrence (p < 0.05). Competing risk analysis indicated radiotherapy alone had a higher recurrence relative to chemoradiotherapy (HR 1.91, CI 1.17-3.09, p = 0.01). CONCLUSIONS:We report the largest study evaluating treatment and outcomes of NPC in a non-endemic population. This unique population falls between described endemic and non-endemic populations. Non-keratinizing pathology and primary radiotherapy did not affect survival; however, both had a propensity for recurrence. Finally, patients experienced more locoregional and less distant recurrence, supporting that this cohort may be amenable to curative salvage therapy.

journal_name

Oral Oncol

journal_title

Oral oncology

authors

Howlett J,Hamilton S,Ye A,Jewett D,Riou-Green B,Prisman E,Thamboo A

doi

10.1016/j.oraloncology.2021.105182

subject

Has Abstract

pub_date

2021-01-24 00:00:00

pages

105182

eissn

1368-8375

issn

1879-0593

pii

S1368-8375(21)00005-1

journal_volume

114

pub_type

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Treatment and outcomes of nasopharyngeal carcinoma in a unique non-endemic population.