title: Subdividing the M1 stage of liver metastasis for nasopharyngeal carcinoma to better predict metastatic survival.
abstract: In nasopharyngeal carcinoma (NPC), the M1 stage of the TNM classification does not differentiate between the site of metastasis or the number of metastatic lesions. However, NPC patients with lung or bone metastases survive longer than do those with liver metastasis (LM). We subdivided the M1 stage of LM to better predict survival in these patients. From the records of 305 NPC patients with LM treated at Sun Yat-sen University Cancer Center between January 2000 and December 2007, we determined the effects of clinical characteristics and the subclassifications of the M1 stage for LM characteristics [the number, size, timing (synchronous vs. metachronous), and distribution of metastases and metastases to other organs] on survival since the diagnosis of LM. Metastatic survival rates were 62% at 1 year, 31% at 2 years, and 21% at 3 years. Having 1-3 metastatic lesions, having lesions less than 5 cm in diameter, and having unilobular LM were better univariate predictors of metastatic survival. Better survival was independently predicted by having one to three (vs. more than three) metastatic lesions (hazards ratio=0.52; 95% CI=0.33-0.82) and unilobular (vs. bilobular) lesions (hazards ratio=0.35; 95% CI=0.22-0.57). The current report constitutes large samples of LM from NPC from our single institution with correlation between LM characteristics and metastatic survival. Patients with NPC and one to three liver metastases or unilobular metastases survive longer than their counterparts, and aggressive treatment should be considered.
authors.affiliation: State Key Laboratory of Oncology in South China and the Department of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
authors.forename: Changchuan
authors.initials: C
authors.lastname: Pan
authors.forename: Ni
authors.initials: N
authors.lastname: He
authors.forename: Ming
authors.initials: M
authors.lastname: Zhao
authors.forename: Yangkui
authors.initials: Y
authors.lastname: Gu
authors.forename: Zilin
authors.initials: Z
authors.lastname: Huang
authors.forename: Wang
authors.initials: W
authors.lastname: Li
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Xia
authors.forename: Peihong
authors.initials: P
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma; D002648:Child; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality* / Q000556:secondary*; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D055815:Young Adult
references.citation: Eur J Cancer. 2003 Jul;39(11):1535-41
references.pmid: 12855259
references.citation: CA Cancer J Clin. 2008 May-Jun;58(3):180-90
references.pmid: 18460593
references.citation: Eur Radiol. 2009 May;19(5):1206-13
references.pmid: 19137310
references.citation: Cancer. 2004 Jul 15;101(2):300-6
references.pmid: 15241827
references.citation: Ai Zheng. 2007 Feb;26(2):212-5
references.pmid: 17298756
references.citation: Radiother Oncol. 1997 Apr;43(1):53-61
references.pmid: 9165137
references.citation: East Afr Med J. 2001 Dec;78(12):678-81
references.pmid: 12199453
references.citation: Int J Radiat Oncol Biol Phys. 2001 Jul 1;50(3):717-26
references.pmid: 11395240
references.citation: J Clin Oncol. 2000 Mar;18(6):1324-30
references.pmid: 10715304
references.citation: Am J Otolaryngol. 1995 Mar-Apr;16(2):103-8
references.pmid: 7540805
references.citation: Jpn J Clin Oncol. 1997 Oct;27(5):336-9
references.pmid: 9390212
references.citation: Int J Radiat Oncol Biol Phys. 1992;23(2):261-70
references.pmid: 1587745
references.citation: J Otolaryngol. 1991 Feb;20(1):27-9
references.pmid: 1709423
references.citation: Hepatobiliary Pancreat Dis Int. 2006 Nov;5(4):610-2
references.pmid: 17085352
references.citation: Cancer. 2004 Jan 1;100(1):1-5
references.pmid: 14692017
references.citation: Kaohsiung J Med Sci. 1996 Apr;12(4):229-34
references.pmid: 8683644
references.citation: Cancer. 1996 Jun 15;77(12):2423-31
references.pmid: 8640688
references.citation: Cancer. 1983 Jul 15;52(2):362-8
references.pmid: 6190547
references.citation: Lung Cancer. 2001 May;32(2):129-36
references.pmid: 11325483