Subdivision of M category for nasopharyngeal carcinoma with synchronous metastasis: time to expand the M categorization system.
Subdivision of M category for nasopharyngeal carcinoma with synchronous metastasis: time to expand the M categorization system.
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DOI：
10.1186/s40880-015-0031-9
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发表时间：
2015-08-12
影响因子：
--
通讯作者：
Wu PH
中科院分区：
文献类型：
--
作者：
Shen LJ;Wang SY;Xie GF;Zeng Q;Chen C;Dong AN;Huang ZM;Pan CC;Xia YF;Wu PH
The current metastatic category (M) of nasopharyngeal carcinoma (NPC) is a “catch-all” classification, covering a heterogeneous group of tumors ranging from potentially curable to incurable. The aim of this study was to design an M categorization system that could be applied in planning the treatment of NPC with synchronous metastasis. A total of 505 NPC patients diagnosed with synchronous metastasis at Sun Yat-sen University Cancer Center between 2000 and 2009 were involved. The associations of clinical variables, metastatic features, and a proposed M categorization system with overall survival (OS) were determined by using Cox regression model. Multivariate analysis showed that Union for International Cancer Control (UICC) N category (N1–3/N0), number of metastatic lesions (multiple/single), liver involvement (yes/no), radiotherapy to primary tumor (yes/no), and cycles of chemotherapy (>4/≤4) were independent prognostic factors for OS. We defined the following subcategories based on liver involvement and the number of metastatic lesions: M1a, single lesion confined to an isolated organ or location except the liver; M1b, single lesion in the liver and/or multiple lesions in any organs or locations except the liver; and M1c, multiple lesions in the liver. Of the 505 cases, 74 (14.7%) were classified as M1a, 296 (58.6%) as M1b, 134 (26.5%) as M1c, and 1 was not specified. The three M1 subcategories showed significant difference in OS [M1b vs. M1a, hazard ratio (HR) = 1.69, 95% confidence interval (CI) = 1.16–2.48, P = 0.007; M1c vs. M1a, HR = 2.64, 95% CI = 1.75–3.98, P < 0.001]. We developed an M categorization system based on the independent factors related to the prognosis of patients with metastatic NPC. This system may be helpful to further optimize individualized care for NPC patients.
