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Long-Term Outcomes of Nasopharyngeal Carcinoma by Epstein–Barr Virus Status in the Chinese Population: A Multicenter Investigation

Background: Because the vast majority of nasopharyngeal carcinoma (NPC) in Chinese patients is a direct result of Epstein–Barr virus (EBV) infection, there is a dearth of data for EBV-negative patients in this population. This multicenter study sought to examine the clinical characteristics of EBV-n...

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Autores principales: Xiong, Yudi, Yuan, Mengting, Liu, Zhigang, Huang, Jing, Bi, Jianping, Pi, Guoliang, Li, Ying, Li, Yanping, He, Hanping, Verma, Vivek, Tian, Suqing, Han, Guang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145834/
https://www.ncbi.nlm.nih.gov/pubmed/37109338
http://dx.doi.org/10.3390/jcm12083005
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author Xiong, Yudi
Yuan, Mengting
Liu, Zhigang
Huang, Jing
Bi, Jianping
Pi, Guoliang
Li, Ying
Li, Yanping
He, Hanping
Verma, Vivek
Tian, Suqing
Han, Guang
author_facet Xiong, Yudi
Yuan, Mengting
Liu, Zhigang
Huang, Jing
Bi, Jianping
Pi, Guoliang
Li, Ying
Li, Yanping
He, Hanping
Verma, Vivek
Tian, Suqing
Han, Guang
author_sort Xiong, Yudi
collection PubMed
description Background: Because the vast majority of nasopharyngeal carcinoma (NPC) in Chinese patients is a direct result of Epstein–Barr virus (EBV) infection, there is a dearth of data for EBV-negative patients in this population. This multicenter study sought to examine the clinical characteristics of EBV-negative patients and compare long-term outcomes with a propensity-matched (1:1.5) EBV-positive cohort. Methods: NPC patients with known EBV status from four hospitals were collated (2013–2021). A logistic regression model was conducted to evaluate the relationship between patient characteristics and EBV status. The Kaplan–Meier method and Cox regression analysis were used to analyze survival data. Results: This study analyzed 48 (40%) EBV-negative and 72 (60%) EBV-positive patients. The median follow-up time was 63.5 months. Most EBV-negative NPC patients (77.1%) were diagnosed in advanced stages with a higher rate (87.5%) of positive lymph node disease, and no significant prognostic factors were discerned in this subpopulation. The EBV-negative disease was more associated with the keratinizing subtype (18.8% vs. 1.4%, p < 0.05). Compared to EBV-negative NPC patients, EBV-positive NPC patients were more likely to develop a local recurrence (9.7% vs. 0%, p = 0.026). There was no statistical difference in mortality (EBV-negative vs. EBV- positive, 8.3% vs. 4.2%, p = 0.34) during the follow-up period. Although the median PFS and median OS were not reached, the 3-year PFS rate was 68.8% vs. 70.8% (EBV-negative vs. EBV-positive, p = 0.06), the 3-year OS rate was 70.8% vs. 76.4% (EBV-negative vs. EBV-positive, p = 0.464), the 5-year PFS rate was 56.3% vs. 50% (EBV-negative vs. EBV-positive, p = 0.451), and the 5-year OS rate was 56.3% vs. 58.3% (EBV-negative vs. EBV-positive, p = 0.051), respectively. These data show that EBV-positive NPC patients seem to have a tendency to gain better survival compared with EBV-negative NPC patients. Conclusions: Most of the EBV-negative patients were in the middle and late stages at the time of diagnosis and were more associated with the keratinizing subtype. EBV status may be associated with prognosis in NPC. EBV positivity seems to be associated with better survival in NPC patients. Still, due to the small cohort of patients and the short observation period for a number of patients, further work is required to corroborate these conclusions.
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spelling pubmed-101458342023-04-29 Long-Term Outcomes of Nasopharyngeal Carcinoma by Epstein–Barr Virus Status in the Chinese Population: A Multicenter Investigation Xiong, Yudi Yuan, Mengting Liu, Zhigang Huang, Jing Bi, Jianping Pi, Guoliang Li, Ying Li, Yanping He, Hanping Verma, Vivek Tian, Suqing Han, Guang J Clin Med Brief Report Background: Because the vast majority of nasopharyngeal carcinoma (NPC) in Chinese patients is a direct result of Epstein–Barr virus (EBV) infection, there is a dearth of data for EBV-negative patients in this population. This multicenter study sought to examine the clinical characteristics of EBV-negative patients and compare long-term outcomes with a propensity-matched (1:1.5) EBV-positive cohort. Methods: NPC patients with known EBV status from four hospitals were collated (2013–2021). A logistic regression model was conducted to evaluate the relationship between patient characteristics and EBV status. The Kaplan–Meier method and Cox regression analysis were used to analyze survival data. Results: This study analyzed 48 (40%) EBV-negative and 72 (60%) EBV-positive patients. The median follow-up time was 63.5 months. Most EBV-negative NPC patients (77.1%) were diagnosed in advanced stages with a higher rate (87.5%) of positive lymph node disease, and no significant prognostic factors were discerned in this subpopulation. The EBV-negative disease was more associated with the keratinizing subtype (18.8% vs. 1.4%, p < 0.05). Compared to EBV-negative NPC patients, EBV-positive NPC patients were more likely to develop a local recurrence (9.7% vs. 0%, p = 0.026). There was no statistical difference in mortality (EBV-negative vs. EBV- positive, 8.3% vs. 4.2%, p = 0.34) during the follow-up period. Although the median PFS and median OS were not reached, the 3-year PFS rate was 68.8% vs. 70.8% (EBV-negative vs. EBV-positive, p = 0.06), the 3-year OS rate was 70.8% vs. 76.4% (EBV-negative vs. EBV-positive, p = 0.464), the 5-year PFS rate was 56.3% vs. 50% (EBV-negative vs. EBV-positive, p = 0.451), and the 5-year OS rate was 56.3% vs. 58.3% (EBV-negative vs. EBV-positive, p = 0.051), respectively. These data show that EBV-positive NPC patients seem to have a tendency to gain better survival compared with EBV-negative NPC patients. Conclusions: Most of the EBV-negative patients were in the middle and late stages at the time of diagnosis and were more associated with the keratinizing subtype. EBV status may be associated with prognosis in NPC. EBV positivity seems to be associated with better survival in NPC patients. Still, due to the small cohort of patients and the short observation period for a number of patients, further work is required to corroborate these conclusions. MDPI 2023-04-20 /pmc/articles/PMC10145834/ /pubmed/37109338 http://dx.doi.org/10.3390/jcm12083005 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Xiong, Yudi
Yuan, Mengting
Liu, Zhigang
Huang, Jing
Bi, Jianping
Pi, Guoliang
Li, Ying
Li, Yanping
He, Hanping
Verma, Vivek
Tian, Suqing
Han, Guang
Long-Term Outcomes of Nasopharyngeal Carcinoma by Epstein–Barr Virus Status in the Chinese Population: A Multicenter Investigation
title Long-Term Outcomes of Nasopharyngeal Carcinoma by Epstein–Barr Virus Status in the Chinese Population: A Multicenter Investigation
title_full Long-Term Outcomes of Nasopharyngeal Carcinoma by Epstein–Barr Virus Status in the Chinese Population: A Multicenter Investigation
title_fullStr Long-Term Outcomes of Nasopharyngeal Carcinoma by Epstein–Barr Virus Status in the Chinese Population: A Multicenter Investigation
title_full_unstemmed Long-Term Outcomes of Nasopharyngeal Carcinoma by Epstein–Barr Virus Status in the Chinese Population: A Multicenter Investigation
title_short Long-Term Outcomes of Nasopharyngeal Carcinoma by Epstein–Barr Virus Status in the Chinese Population: A Multicenter Investigation
title_sort long-term outcomes of nasopharyngeal carcinoma by epstein–barr virus status in the chinese population: a multicenter investigation
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145834/
https://www.ncbi.nlm.nih.gov/pubmed/37109338
http://dx.doi.org/10.3390/jcm12083005
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