A retrospective cohort study of nasopharyngeal adenocarcinoma: a rare histological type of nasopharyngeal cancer.
OBJECTIVE
The purpose of this study was to investigate the clinical manifestations, Epstein-Barr virus (EBV) serology, and treatment outcome of patients with nasopharyngeal adenocarcinoma (NPAC).


METHODS
A retrospective study of clinical data from consecutive patients with NPAC identified between 1964 and 2000.


METHODS
A tertiary cancer center in China.


METHODS
Forty-eight patients diagnosed with NPAC.


METHODS
Crosstabs and chi-square test were conducted to study the association of positive VCA-IgA levels among different pathological types of NPAC, and also to compare the proportions of local control rates in patients treated with different modalities. The survival rate was calculated using the Kaplan-Meier method, and the Log Rank test was used to compare the survival rates considering different factors. To balance the distribution bias, a multivariate COX model survival analysis was also performed.


RESULTS
Of the 48 NPAC patients identified, 45% presented with cervical metastasis. Pathologically, 58% of NPAC cases were common type and 42% were salivary gland type. The positive rate for the EBV antibody VCA-IgA in all patients was 53% and only 24% in the salivary gland type of NPAC. The overall local control rate and the 5-year disease-free survival rates were 87% and 65% respectively. Patients treated with surgery plus radiotherapy (RT) had a significantly higher 5-year disease-free survival rate than patients receiving RT alone (89%versus 75% respectively) (P = 0.039). Multivariate analysis confirmed that treatment modality was the significant factor influencing patient survival (P = 0.027) and the pathological type was not a factor predicting survival.


CONCLUSIONS
Nasopharyngeal adenocarcinoma is a distinct entity in all types of nasopharyngeal carcinoma and EBV serology has limited value in its diagnosis. The combination of surgery and RT should be considered for treatment of early lesions of NPAC.
Guo
Z M
ZM
Department of Head and Neck Surgery, Cancer Center of Sun Yat-Sen University, Guangzhou, China.
Liu
W W
WW
He
J H
JH
D000230:Adenocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000956:Antigens, Viral / Q000276:immunology; D002173:Cancer Care Facilities; D036022:Capsid Proteins / Q000276:immunology; D002681:China; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009305:Nasopharynx / Q000473:pathology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D055815:Young Adult
D000956:Antigens, Viral; D036022:Capsid Proteins; C041788:Epstein-Barr viral capsid antigen; D007070:Immunoglobulin A