title: Oligometastases in AJCC stage IVc nasopharyngeal carcinoma: A subset with better overall survival.
abstract: 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).
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Radiation Oncology, Cancer Center of Guangzhou Medical University, Guangzhou, China.
authors.forename: Yun-Hong
authors.initials: YH
authors.lastname: Tian
authors.affiliation: Department of Radiation Oncology, Hui Zhou Municipal Central Hospital, Guangzhou, China.
authors.forename: Wen-Hui
authors.initials: WH
authors.lastname: Zou
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Province, People's Republic of China.
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Xiao
authors.affiliation: Department of Radiation Oncology, Jiangxi Cancer Hospital, Nanchang, Jiangxi, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zeng
authors.affiliation: Department of Medical Oncology, Hui Zhou Municipal Central Hospital, Guangzhou, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Yuan
authors.affiliation: Department of Radiation Oncology, Hui Zhou Municipal Central Hospital, Guangzhou, China.
authors.forename: Li
authors.initials: L
authors.lastname: Bai
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Province, People's Republic of China.
authors.forename: Taixiang
authors.initials: T
authors.lastname: Lu
authors.affiliation: Department of Radiation Oncology, Hui Zhou Municipal Central Hospital, Guangzhou, China.
authors.forename: Yunming
authors.initials: Y
authors.lastname: Tian
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Province, People's Republic of China.
authors.forename: Fei
authors.initials: F
authors.lastname: Han
mesh_terms: D026683:Advisory Committees; D000704:Analysis of Variance; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary; D002277:Carcinoma / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D002423:Cause of Death; D059186:Chemoradiotherapy, Adjuvant; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007825:Laryngectomy / Q000379:methods; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary; D008297:Male; D015999:Multivariate Analysis; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D009361:Neoplasm Invasiveness / Q000473:pathology; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D014481:United States
keywords: chemotherapy; metastasis; nasopharyngeal carcinoma; prognostic model; radiotherapy