Background: The prognostic impact of internal carotid artery (ICA) invasion in nasopharyngeal cancer (NPC) patients is not well established. Thus, we conducted a retrospective study to analyze the prognostic factors for ICA invasion by NPC. Methods: This retrospective study included consecutive biopsy-proven NPC patients who received CCRT from November 2015 to December 2022 at E-Da Hospital. Patients were then classified into two groups according to ICA invasion by tumor or not. Survival was estimated by the Kaplan–Meier method with a five-year overall survival (OS) rate and five-year disease specific survival (DSS) rate. Results: A total of 191 patients with pathologically confirmed NPC were included in this study, with 54 patients in the ICA invasion group and 137 patients in the no ICA invasion group. The ICA invasion group showed a worse prognosis compared to the no ICA invasion group (p< 0.001 in OS and DSS). Patients were stratified into a poor response group and good response group. OS and DSS in the poor response group had a significant difference compared to the good response group (bothp< 0.001). In multivariate analysis, NLR was an independently prognostic factor for OS (HR 2.430, 95% CI 1.040–5.678,p= 0.040 and HR 0.412, 95% CI 0.176–0.962,p= 0.040, respectively) and for DSS (HR 2.430, 95% CI 1.040–5.678,p= 0.040 and HR 0.412, 95% CI 0.176–0.962,p= 0.040, respectively). Conclusions: Locally advanced NPC patients with ICA invasion have a miserable outcome and NLR represents a significant prognostic factor that impacts treatment decisions and survival.
背景：鼻咽癌患者颈内动脉受侵的预后影响尚未明确。为此，我们开展了一项回顾性研究，旨在分析鼻咽癌侵犯颈内动脉的预后因素。方法：本研究回顾性纳入2015年11月至2022年12月在义大医院连续收治的经活检证实并接受同步放化疗的鼻咽癌患者。根据肿瘤是否侵犯颈内动脉将患者分为两组。采用Kaplan-Meier法评估生存情况，计算五年总生存率和五年疾病特异性生存率。结果：本研究共纳入191例病理确诊的鼻咽癌患者，其中颈内动脉受侵组54例，未受侵组137例。与未受侵组相比，颈内动脉受侵组预后更差（总生存率与疾病特异性生存率均p<0.001）。将患者分为治疗反应不良组与反应良好组，反应不良组的总生存率与疾病特异性生存率均显著低于反应良好组（均p<0.001）。多变量分析显示，中性粒细胞与淋巴细胞比值是总生存率（HR 2.430，95% CI 1.040–5.678，p=0.040；HR 0.412，95% CI 0.176–0.962，p=0.040）和疾病特异性生存率（HR 2.430，95% CI 1.040–5.678，p=0.040；HR 0.412，95% CI 0.176–0.962，p=0.040）的独立预后因素。结论：伴有颈内动脉受侵的局部晚期鼻咽癌患者预后不良，中性粒细胞与淋巴细胞比值是影响治疗决策和生存的重要预后指标。
Analysis of Prognostic Factors for Internal Carotid Artery Invasion by Nasopharyngeal Carcinoma
肿瘤(癌症)患者之家