A large-scale retrospective study of the overall survival outcome in nasopharyngeal carcinoma with hypertension in Chinese population

BACKGROUND: It is known that hypertension is associated with high levels of vascular endothelial growth factor (VEGF) expression which is, in turn, highly connected to the prognosis of a wide array of cancers. The purpose of this study was to evaluate the relationship between hypertension and prognosis of nasopharyngeal carcinoma (NPC) with definitive radiotherapy in a Chinese population. PATIENTS AND METHODS: We retrospectively reviewed 4493 patients with NPC who received definitive radiotherapy from 1995 to 2006, with a minimum follow-up of 5 years. Kaplan-Meier survival analysis and Cox proportional hazard model were utilized to determine the association between hypertension and overall survival (OS). RESULTS: A total of 802 patients with NPC suffered from hypertension as compared to 3691 patients with no associated hypertension. Kaplan-Meier analysis revealed median overall survival of 101.1 and 110.0 months, respectively (p<0.05). In univariate survival analysis, patients with hypertension had worse OS (p<0.05) than non-hypertension patients. Patients with higher grade hypertension also had worse OS (p<0.05) compare to patients with grade 1 hypertension. In multivariate survival analysis, patients with hypertension had significantly worse OS (p<0.05) than non-hypertension patients, as well as M stage (p<0.001), after adjustment for related clinical confounding factors. CONCLUSION: Our findings provide evidence that hypertension is an independent factor and result in poorer survival outcomes in patients with NPC, the mechanism is still unclear, and it worth further research.