T4N0M0 nasopharyngeal carcinoma patients: do they have a distinct tumor biology?

Yıl 2010, Cilt: 20 Sayı: 2, 89 - 96, 20.03.2010

Beste M. Atasoy Enis Özyar Fadime Akman Mustafa Adnan Esassolak Ufuk Abacıoğlu

Öz

Objectives: To investigate the clinical manifestations and treatment outcomes of non-metastatic T4N0 nasopharyngeal cancer patients, and to compare them with other stage IVA subgroups of patients. Patients and Methods: A retrospective analysis of 775 non-metastatic nasopharyngeal cancer patients, treated in four radiotherapy centers between 1990 and 2005, was undertaken. Among 197 stage IVA patients, 90 11.6% patients were staged as T4N0, 32 4.1% as T4N1, and 75 9.7% as T4N2. T4N0 patients constituted 40.8% of all T4 cases median age 53 years; range 15 to 76 years . Cranial nerve involvement was detected in 59 65.5% of these cases. Results: The median follow-up period was 38 months. There were only nine 10% patients younger than 30 years of age with T4N0 tumors, for patients with diseases other than T4N0, 27.1% of the patients were under 30. Survival rates for five-year loco-regional progression free survival, distant failure free survival, and disease specific survival were 65.9%, 94%, and 71.4%, respectively. Distant failure free survival of T4N0 patients was more probable than for stage T4N1 p=0.06 and T4N2 p=0.008 patients. Conclusion: Non-metastatic T4N0 tumors have some distinct features, including a unimodal age distribution and a better distant failure free survival than the other subgroups of stage IVA. Therefore, it may be better to include T4N0 patients in stage III instead of stage IVA.

Anahtar Kelimeler

Nasopharyngeal cancer, recurrence patterns, stage T4N0M0

T4N0M0 nazofarenks kanseri hastalarının farklı bir tümör biyolojisi olabilir mi?

Öz

Amaç: Tümörleri T4N0 olarak evrelenen metastatik olmayan nazofarenks kanserli hastaların tedavi ve klinik özellikleri incelendi; elde edilen sonuçlar evre IVA’nın diğer alt gruplarında yer alan hastaların sonuçları ile karşılaştırıldı.Hastalar ve Yöntemler: Dört radyoterapi merkezinde 1990 ve 2005 yılları arasında tedavi edilmiş metastatik olmayan toplam 775 nazofarenks kanseri tanılı hasta geriye dönük incelendi. Bu hastalardan evre IVA olan 197’sinin dağılımı; 90’ı %11.6 T4N0, 32’si %4.1 T4N1ve 75’i %9.7 T4N2 şeklindeydi. T4N0 hastalar tüm T4hastalarının %40.8’ini ortanca yaş 53 yıl; dağılım 15-76 yıl oluşturmaktaydı. Kraniyal sinir tutulumu bu hastalardan 59’unda %65.5 izlendi.Bulgular: Ortanca takip süresi 38 ay idi. T4N0 hastalardan sadece dokuzu %10 30 yaş altı iken diğer T4N0 alt gruplarındaki hastaların ise %27.1’i 30 yaş altında idi. Beş yıllık lokal bölgesel progresyonsuz sağkalım, uzak metastazsız sağkalım ve hastalıksız sağkalım oranları sırasıyla %65.9, %94 ve %71.4 idi. Uzak metastazsız sağkalım evre T4N0 hastalarda diğer T4N1 p=0.06 ve T4N2 p=0.008 evre hastalarından daha iyi idi.Sonuç: Metastatik olmayan T4N0 tümörler, unimodal yaş dağılımları ve daha iyi uzak metastazsız sağkalım sonuçları açısından, diğer evre IVA alt gruplarından farklı özellikler göstermektedir. Bu nedenle bu hastaların evre IVA yerine evre III olarak değerlendirilmesi uygun olabilir

Anahtar Kelimeler

Nazofarenks kanseri, nüks özellikleri, evre T4NM

Kaynakça

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