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- Title
Benefits of local tumor excision and pharyngectomy on the survival of nasopharyngeal carcinoma patients: a retrospective observational study based on SEER database.
- Authors
Jian Sun; Zhongying Huang; Zheyu Hu; Rui Sun; Sun, Jian; Huang, Zhongying; Hu, Zheyu; Sun, Rui
- Abstract
<bold>Background: </bold>There is ongoing debate about surgery of primary site in nasopharyngeal carcinoma patients.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>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.
- Subjects
UNITED States; 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
- Publication
Journal of Translational Medicine, 2017, Vol 15, p1
- ISSN
1479-5876
- Publication type
journal article
- DOI
10.1186/s12967-017-1204-x