title: Pregnancy associated nasopharyngeal carcinoma: A retrospective case-control analysis of maternal survival outcomes.
abstract: BACKGROUND
  Pregnancy-associated nasopharyngeal carcinoma (PANPC) has been associated with poor survival. Recent advances in radiation technology and imaging techniques, and the introduction of chemotherapy have improved survival in nasopharyngeal carcinoma (NPC); however, it is not clear whether these changes have improved survival in PANPC. Therefore, the purpose of this study was to compare five-year maternal survival in patients with PANPC and non-pregnant patients with NPC.
  
  
  METHODS
  After adjusting for age, stage and chemotherapy mode, we conducted a retrospective case-control study among 36 non-metastatic PANPC patients and 36 non-pregnant NPC patients (control group) who were treated at our institution between 2000 and 2010.
  
  
  RESULTS
  The median age of both groups was 30years (range, 23-35years); median follow-up for all patients was 70months. Locoregionally-advanced disease accounted for 83.3% of all patients with PANPC and 92.9% of patients who developed NPC during pregnancy. In both the PANPC and control groups, 31 patients (86.1%) received chemotherapy and all patients received definitive radiotherapy. The five-year rates for overall survival (70% vs. 78%, p=0.72), distant metastasis-free survival (79% vs. 76%, p=0.77), loco-regional relapse-free survival (97% vs. 91%, p=0.69) and disease-free survival (69% vs. 74%, p=0.98) were not significantly different between the PANPC and control groups. Multivariate analysis using a Cox proportional hazards model revealed that only N-classification was significantly associated with five-year OS.
  
  
  CONCLUSIONS
  This study demonstrates that, in the modern treatment era, pregnancy itself may not negatively influence survival outcomes in patients with NPC; however, pregnancy may delay the diagnosis of NPC.
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China; Department of Radiation Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University (Gastrointestinal and Anal Hospital of Sun Yat-sen University), Yuancun Er Heng Lu, Guangzhou, People's Republic of China.
authors.forename: Yi-Kan
authors.initials: YK
authors.lastname: Cheng
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Ling-Long
authors.initials: LL
authors.lastname: Tang
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Guan-Qun
authors.initials: GQ
authors.lastname: Zhou
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Mu-Sheng
authors.initials: MS
authors.lastname: Zeng
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Tie-Bang
authors.initials: TB
authors.lastname: Kang
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Jia
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Molecular Diagnostics, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Jian-Yong
authors.initials: JY
authors.lastname: Shao
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Nasopharyngeal Cancer, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Hai-Qiang
authors.initials: HQ
authors.lastname: Mai
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of National Clinical Study Center for Anticancer Drugs, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Guo
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. Electronic address: majun2@mail.sysu.edu.cn.
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
mesh_terms: D000328:Adult; D002277:Carcinoma; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000209:etiology / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000401:mortality* / Q000473:pathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055815:Young Adult
keywords: Chemotherapy; Nasopharyngeal carcinoma; Pregnancy-associated nasopharyngeal carcinoma; Prognosis