1. Benefits of local tumor excision and pharyngectomy on the survival of nasopharyngeal carcinoma patients: a retrospective observational study based on SEER database.
- Author
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Jian Sun, Zhongying Huang, Zheyu Hu, Rui Sun, Sun, Jian, Huang, Zhongying, Hu, Zheyu, and Sun, Rui
- Subjects
TUMOR proteins ,NASOPHARYNGOSCOPY ,SURVIVAL analysis (Biometry) ,PROPORTIONAL hazards models ,CARCINOMA ,THERAPEUTICS ,EPIDEMIOLOGY of cancer ,CANCER-related mortality ,ONCOLOGIC surgery ,DATABASES ,REPORTING of diseases ,ETHNIC groups ,NASOPHARYNX tumors ,PHARYNX surgery ,PROBABILITY theory ,RADIOTHERAPY ,TUMOR classification ,TREATMENT effectiveness ,RETROSPECTIVE studies ,KAPLAN-Meier estimator - Abstract
Background: There is ongoing debate about surgery of primary site in nasopharyngeal carcinoma patients.Methods: 3919 patients with nasopharyngeal carcinoma identified in the SEER registry between 2004 and 2013. The benefit of surgery of primary nasopharynx tumor site on overall and cancer-specific survival was assessed by risk-adjusted multivariate Cox proportional hazard regression and propensity score matching modeling.Results: Surgery was marginally associated with better overall survival (hazard ratio (HR) = 0.816, 95% CI 0.656-1.015, p = 0.07) and cancer-specific survival (HR = 0.749, 95% CI 0.552-1.018, p = 0.06) in the propensity score model. Among 398 cases who underwent primary site surgery, 282 (70.85%) received local tumor excision and 79 (20.31%) received pharyngectomy. Local tumor excision and pharyngectomy had almost the same effect on survival in propensity score matching analysis. The benefit was significant in subgroups of white, age <60 year, and patients with T3, N1, M0, AJCC stage III, or moderately differentiated tumors. Further survival analysis showed surgery to promote survival in both radiotherapy and non-radiotherapy patients.Conclusion: This is the first population-based analysis using propensity score model to provide evidence of a positive impact of surgery on survival in nasopharyngeal carcinoma. Moreover, surgery demonstrated the significant benefit in subgroups of patients with specific clinical characteristics. [ABSTRACT FROM AUTHOR]- Published
- 2017
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