A new prognostic histopathologic classification of nasopharyngeal carcinoma
Abstract Background The current World Health Organization (WHO) classification of nasopharyngeal carcinoma (NPC) conveys little prognostic information. This study aimed to propose an NPC histopathologic classification that can potentially be used to predict prognosis and treatment response. Methods...
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BMC
2016-05-01
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| Series: | Chinese Journal of Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s40880-016-0103-5 |
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| author | Hai-Yun Wang Yih-Leong Chang Ka-Fai To Jacqueline S. G. Hwang Hai-Qiang Mai Yan-Fen Feng Ellen T. Chang Chen-Ping Wang Michael Koon Ming Kam Shie-Lee Cheah Ming Lee Li Gao Hui-Zhong Zhang Jie-Hua He Hao Jiang Pei-Qing Ma Xiao-Dong Zhu Liang Zeng Chun-Yan Chen Gang Chen Ma-Yan Huang Sha Fu Qiong Shao An-Jia Han Hai-Gang Li Chun-Kui Shao Pei-Yu Huang Chao-Nan Qian Tai-Xiang Lu Jin-Tian Li Weimin Ye Ingemar Ernberg Ho Keung Ng Joseph T. S. Wee Yi-Xin Zeng Hans-Olov Adami Anthony T. C. Chan Jian-Yong Shao |
| author_facet | Hai-Yun Wang Yih-Leong Chang Ka-Fai To Jacqueline S. G. Hwang Hai-Qiang Mai Yan-Fen Feng Ellen T. Chang Chen-Ping Wang Michael Koon Ming Kam Shie-Lee Cheah Ming Lee Li Gao Hui-Zhong Zhang Jie-Hua He Hao Jiang Pei-Qing Ma Xiao-Dong Zhu Liang Zeng Chun-Yan Chen Gang Chen Ma-Yan Huang Sha Fu Qiong Shao An-Jia Han Hai-Gang Li Chun-Kui Shao Pei-Yu Huang Chao-Nan Qian Tai-Xiang Lu Jin-Tian Li Weimin Ye Ingemar Ernberg Ho Keung Ng Joseph T. S. Wee Yi-Xin Zeng Hans-Olov Adami Anthony T. C. Chan Jian-Yong Shao |
| author_sort | Hai-Yun Wang |
| collection | DOAJ |
| description | Abstract Background The current World Health Organization (WHO) classification of nasopharyngeal carcinoma (NPC) conveys little prognostic information. This study aimed to propose an NPC histopathologic classification that can potentially be used to predict prognosis and treatment response. Methods We initially developed a histopathologic classification based on the morphologic traits and cell differentiation of tumors of 2716 NPC patients who were identified at Sun Yat-sen University Cancer Center (SYSUCC) (training cohort). Then, the proposed classification was applied to 1702 patients (retrospective validation cohort) from hospitals outside SYSUCC and 1613 patients (prospective validation cohort) from SYSUCC. The efficacy of radiochemotherapy and radiotherapy modalities was compared between the proposed subtypes. We used Cox proportional hazards models to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for overall survival (OS). Results The 5-year OS rates for all NPC patients who were diagnosed with epithelial carcinoma (EC; 3708 patients), mixed sarcomatoid-epithelial carcinoma (MSEC; 1247 patients), sarcomatoid carcinoma (SC; 823 patients), and squamous cell carcinoma (SCC; 253 patients) were 79.4%, 70.5%, 59.6%, and 42.6%, respectively (P < 0.001). In multivariate models, patients with MSEC had a shorter OS than patients with EC (HR = 1.44, 95% CI = 1.27–1.62), SC (HR = 2.00, 95% CI = 1.76–2.28), or SCC (HR = 4.23, 95% CI = 3.34–5.38). Radiochemotherapy significantly improved survival compared with radiotherapy alone for patients with EC (HR = 0.67, 95% CI = 0.56–0.80), MSEC (HR = 0.58, 95% CI = 0.49–0.75), and possibly for those with SCC (HR = 0.63; 95% CI = 0.40–0.98), but not for patients with SC (HR = 0.97, 95% CI = 0.74–1.28). Conclusions The proposed classification offers more information for the prediction of NPC prognosis compared with the WHO classification and might be a valuable tool to guide treatment decisions for subtypes that are associated with a poor prognosis. |
| first_indexed | 2024-12-20T04:38:18Z |
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| id | doaj.art-1c07513f8e9d4a92b7d071d9a4fa0feb |
| institution | Directory Open Access Journal |
| issn | 1944-446X |
| language | English |
| last_indexed | 2024-12-20T04:38:18Z |
| publishDate | 2016-05-01 |
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| series | Chinese Journal of Cancer |
| spelling | doaj.art-1c07513f8e9d4a92b7d071d9a4fa0feb2022-12-21T19:53:11ZengBMCChinese Journal of Cancer1944-446X2016-05-0135111610.1186/s40880-016-0103-5A new prognostic histopathologic classification of nasopharyngeal carcinomaHai-Yun Wang0Yih-Leong Chang1Ka-Fai To2Jacqueline S. G. Hwang3Hai-Qiang Mai4Yan-Fen Feng5Ellen T. Chang6Chen-Ping Wang7Michael Koon Ming Kam8Shie-Lee Cheah9Ming Lee10Li Gao11Hui-Zhong Zhang12Jie-Hua He13Hao Jiang14Pei-Qing Ma15Xiao-Dong Zhu16Liang Zeng17Chun-Yan Chen18Gang Chen19Ma-Yan Huang20Sha Fu21Qiong Shao22An-Jia Han23Hai-Gang Li24Chun-Kui Shao25Pei-Yu Huang26Chao-Nan Qian27Tai-Xiang Lu28Jin-Tian Li29Weimin Ye30Ingemar Ernberg31Ho Keung Ng32Joseph T. S. Wee33Yi-Xin Zeng34Hans-Olov Adami35Anthony T. C. Chan36Jian-Yong Shao37State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Pathology, National Taiwan University Hospital, National Taiwan University College of MedicineDepartment of Anatomical and Cellular Pathology, Hong Kong Cancer Institute and Sir YK Pao Centre for Cancer, Faculty of Medicine, The Chinese University of Hong KongDepartment of Pathology, Singapore General HospitalState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDivision of Epidemiology, Department of Health Research and Policy, Stanford University School of MedicineDepartment of Otolaryngology, National Taiwan University Hospital, National Taiwan University College of MedicineDepartment of Clinical Oncology, Hong Kong Cancer Institute and Sir YK Pao Centre for Cancer, Faculty of Medicine, The Chinese University of Hong KongDivision of Radiation Oncology, National Cancer CenterDepartment of Pathology, Singapore General HospitalDepartment of Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical SciencesState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Radiation Oncology, The Affiliated Hospital of Bengbu Medical CollegeDepartment of Pathology, Cancer Institute and Hospital, Chinese Academy of Medical SciencesDepartment of Radiation Oncology, Guangxi Medical UniversityDepartment of Pathology, Hunan Provincial Cancer HospitalState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Pathology, Fujian Provincial Cancer HospitalState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Pathology, The First Affiliated Hospital, Sun Yat-sen UniversityDepartment of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityDepartment of Pathology, The Third Affiliated Hospital, Sun Yat-sen UniversityState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Pathology, Hunan Provincial Cancer HospitalState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Medical Epidemiology and Biostatistics, Karolinska InstitutetDepartments of Microbiology and Tumor Biology Center, Karolinska InstitutetDepartment of Anatomical and Cellular Pathology, Hong Kong Cancer Institute and Sir YK Pao Centre for Cancer, Faculty of Medicine, The Chinese University of Hong KongDepartment of Clinical Oncology, Hong Kong Cancer Institute and Sir YK Pao Centre for Cancer, Faculty of Medicine, The Chinese University of Hong KongState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Medical Epidemiology and Biostatistics, Karolinska InstitutetDepartment of Clinical Oncology, Hong Kong Cancer Institute and Sir YK Pao Centre for Cancer, Faculty of Medicine, The Chinese University of Hong KongState Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterAbstract Background The current World Health Organization (WHO) classification of nasopharyngeal carcinoma (NPC) conveys little prognostic information. This study aimed to propose an NPC histopathologic classification that can potentially be used to predict prognosis and treatment response. Methods We initially developed a histopathologic classification based on the morphologic traits and cell differentiation of tumors of 2716 NPC patients who were identified at Sun Yat-sen University Cancer Center (SYSUCC) (training cohort). Then, the proposed classification was applied to 1702 patients (retrospective validation cohort) from hospitals outside SYSUCC and 1613 patients (prospective validation cohort) from SYSUCC. The efficacy of radiochemotherapy and radiotherapy modalities was compared between the proposed subtypes. We used Cox proportional hazards models to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for overall survival (OS). Results The 5-year OS rates for all NPC patients who were diagnosed with epithelial carcinoma (EC; 3708 patients), mixed sarcomatoid-epithelial carcinoma (MSEC; 1247 patients), sarcomatoid carcinoma (SC; 823 patients), and squamous cell carcinoma (SCC; 253 patients) were 79.4%, 70.5%, 59.6%, and 42.6%, respectively (P < 0.001). In multivariate models, patients with MSEC had a shorter OS than patients with EC (HR = 1.44, 95% CI = 1.27–1.62), SC (HR = 2.00, 95% CI = 1.76–2.28), or SCC (HR = 4.23, 95% CI = 3.34–5.38). Radiochemotherapy significantly improved survival compared with radiotherapy alone for patients with EC (HR = 0.67, 95% CI = 0.56–0.80), MSEC (HR = 0.58, 95% CI = 0.49–0.75), and possibly for those with SCC (HR = 0.63; 95% CI = 0.40–0.98), but not for patients with SC (HR = 0.97, 95% CI = 0.74–1.28). Conclusions The proposed classification offers more information for the prediction of NPC prognosis compared with the WHO classification and might be a valuable tool to guide treatment decisions for subtypes that are associated with a poor prognosis.http://link.springer.com/article/10.1186/s40880-016-0103-5Nasopharyngeal carcinomaPathologic classificationPrognosis |
| spellingShingle | Hai-Yun Wang Yih-Leong Chang Ka-Fai To Jacqueline S. G. Hwang Hai-Qiang Mai Yan-Fen Feng Ellen T. Chang Chen-Ping Wang Michael Koon Ming Kam Shie-Lee Cheah Ming Lee Li Gao Hui-Zhong Zhang Jie-Hua He Hao Jiang Pei-Qing Ma Xiao-Dong Zhu Liang Zeng Chun-Yan Chen Gang Chen Ma-Yan Huang Sha Fu Qiong Shao An-Jia Han Hai-Gang Li Chun-Kui Shao Pei-Yu Huang Chao-Nan Qian Tai-Xiang Lu Jin-Tian Li Weimin Ye Ingemar Ernberg Ho Keung Ng Joseph T. S. Wee Yi-Xin Zeng Hans-Olov Adami Anthony T. C. Chan Jian-Yong Shao A new prognostic histopathologic classification of nasopharyngeal carcinoma Chinese Journal of Cancer Nasopharyngeal carcinoma Pathologic classification Prognosis |
| title | A new prognostic histopathologic classification of nasopharyngeal carcinoma |
| title_full | A new prognostic histopathologic classification of nasopharyngeal carcinoma |
| title_fullStr | A new prognostic histopathologic classification of nasopharyngeal carcinoma |
| title_full_unstemmed | A new prognostic histopathologic classification of nasopharyngeal carcinoma |
| title_short | A new prognostic histopathologic classification of nasopharyngeal carcinoma |
| title_sort | new prognostic histopathologic classification of nasopharyngeal carcinoma |
| topic | Nasopharyngeal carcinoma Pathologic classification Prognosis |
| url | http://link.springer.com/article/10.1186/s40880-016-0103-5 |
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