gms | German Medical Science

87. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

04.05. - 07.05.2016, Düsseldorf

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Tumor volume in early stage nasopharyngeal cancer as a marker for recurrence and overall survival – is everything said?

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  • corresponding author Stefan Mueller - Department of Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
  • Sharon Poh - Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
  • Soong Yoke Lim - Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
  • Teo Tze Hern - Department of Oncologic Imaging, National Cancer Centre Singapore, Singapore, Singapore
  • Lam Wing Chuen - Department of Nuclear Medicine, Singapore General Hospital, Singapore, Singapore
  • Narayanan Gopalakrishna Iyer - Cancer Therapeutics Research Laboratory, National Cancer Centre, Singapore, Singapore, Singapore
  • Tan Hiang Khoon - Department of Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 87. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Düsseldorf, 04.-07.05.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16hnod199

doi: 10.3205/16hnod199, urn:nbn:de:0183-16hnod1990

Veröffentlicht: 30. März 2016

© 2016 Mueller et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Background: Evidence has accumulated that tumor volume (TV) is a significant prognostic marker for nasopharyngeal cancer (NPC). But there is limited and conflicting data about the role of TV in early stage NPC. We thus aim to investigate the prognostic value of TV in early stage NPC.

Methods: 89 patients with stage 1 (n=33) and 2 (n=56) NPC who underwent IMRT between 2005 and 2013 were included. Primary tumor volume (PTV), nodal (NTV) and total tumor volume (TTV) were calculated using staging scans, cut off volumes were defined using receiver operating characteristic (ROC). Overall survival (OS) and recurrence free survival (RFS) have been analyzed with Kaplan-Meier estimate. Cox proportional hazard model was utilized.

Results: Mean follow up was 54 months, 18% (n=16) developed a recurrence, 8% (n=7) died. Mean PTV was 5.13ml for stage 1 and 9.94ml for stage 2 (p<0.001). Mean TTV was 5.13ml for stage 1 and 20.43ml for stage 2 (p<0.001).

A PTV greater 6.6ml showed significant worse OS (p=0.043) and RFS (p=0.004). TTV above 14.1ml showed a significant worse RFS (p=0.002). AJCC stage did not show significant correlation with OS (p=0.78) or RFS (p=0.76). Hazards ratio (RFS) was 1.1 for PTV (p=0.003) and 1.05 for TTV (p=0.001).

Conclusion: PTV and TTV is highly prognostic for RFS and OS in early stage NPC. The AJCC staging system failed to show a high prognostic value in our cohort. These results further clarify on the role of TV in early stage NPC. The data suggests that PTV could serve as an adjunct to the TNM staging system.

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