Lung metastasis alone in nasopharyngeal carcinoma: A relatively favorable prognostic group

BACKGROUND The current study was conducted to examine the pattern and the predictive factors of distant metastases (DM) in patients with nasopharyngeal carcinoma (NPC) after primary radiotherapy treatment. METHODS Data from all five regional cancer centers in Hong Kong were collected retrospectively and pooled for the current study, which was coordinated by the Hong Kong Nasopharyngeal Carcinoma Study Group. The sample was comprised of all 2915 patients with NPC without DM at the time of presentation who were treated with radiotherapy in 1 of the 5 cancer centers during the period between January 1996 and December 2000. RESULTS DM was found to be the leading cause of NPC failure, with a 5-year actuarial rate of 14.9% in this patient cohort. Despite the poor overall survival (OS) of these patients, those with lung metastasis alone represented a distinctive group associated with a significantly better OS. International Union Against Cancer (UICC) N classification, UICC T classification, advanced age, and male gender were found to be significant and independent determinants for DM. CONCLUSIONS Long-term survival is possible in patients with distant metastatic NPC confined to the lung. An aggressive approach to treatment for this group of patients should be considered. Cancer 2004. © 2004 American Cancer Society.