Patterns of failure and prognosis in nasopharyngeal carcinoma according to Epstein-Barr virus DNA status
Abstract Purpose To investigate the patterns of failure and prognosis in recurrent or metastatic nasopharyngeal carcinoma (rmNPC) according to Epstein-Barr virus-DNA (EBV-DNA) status. Methods We included NPC patients who were diagnosed with locoregional recurrence (LRR) and/(or) distant metastasis (...
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BMC
2025-02-01
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| Series: | Infectious Agents and Cancer |
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| Online Access: | https://doi.org/10.1186/s13027-024-00631-1 |
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| author | Lin-Feng Guo Guan-Zhong Lu Zhen-Zhen Lu Yi-Feng Yu San-Gang Wu |
| author_facet | Lin-Feng Guo Guan-Zhong Lu Zhen-Zhen Lu Yi-Feng Yu San-Gang Wu |
| author_sort | Lin-Feng Guo |
| collection | DOAJ |
| description | Abstract Purpose To investigate the patterns of failure and prognosis in recurrent or metastatic nasopharyngeal carcinoma (rmNPC) according to Epstein-Barr virus-DNA (EBV-DNA) status. Methods We included NPC patients who were diagnosed with locoregional recurrence (LRR) and/(or) distant metastasis (DM) between January 2017 and June 2024. Receiver operating characteristic analysis, Chi-square test, Wilcoxon rank sum test, Kaplan-Meier method, and Multivariate Cox regression analyses were used for statistical analysis. Results This study involved 108 patients, including 105 (97.2%) who had EBV-DNA detectable at the initial diagnosis of NPC. Regarding progression patterns, 34 patients (31.5%) experienced only LRR, while 60 patients (55.6%) had only DM. LRR followed by DM was observed in 5 (4.6%) patients, DM followed by LRR occurred in 2 (1.8%) patients, and both LRR and DM were presented simultaneously in 7 (6.5%) patients. EBV-DNA positivity rates significantly differed between LRR and DM patients, at 76.9% and 97.1% respectively (P = 0.003). A significant difference was also observed in EBV-DNA levels, with a median level of 413 copies/mL for LRR and 6,550 copies/mL for DM (P < 0.001). While the EBV-DNA positivity rate did not differ significantly between oligometastatic disease and polymetastatic disease (P = 0.493), the levels were significantly elevated in the polymetastatic disease group than the oligometastatic disease group (P < 0.001). Multivariate analysis showed that liver metastasis (P = 0.012) and EBV-DNA levels ≥ 3,525 copies/mL at progression (P = 0.009) independently correlated with poorer overall survival. Conclusions Our study provides substantial evidence linking higher EBV-DNA levels with disease failure patterns and identifies liver metastasis and EBV-DNA levels at disease progression as independent prognostic factors for poorer overall survival in rmNPC patients. |
| format | Article |
| id | doaj-art-03209244c3ad4a37b296693db00c5760 |
| institution | Kabale University |
| issn | 1750-9378 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Agents and Cancer |
| spelling | doaj-art-03209244c3ad4a37b296693db00c57602025-02-09T12:13:10ZengBMCInfectious Agents and Cancer1750-93782025-02-0120111110.1186/s13027-024-00631-1Patterns of failure and prognosis in nasopharyngeal carcinoma according to Epstein-Barr virus DNA statusLin-Feng Guo0Guan-Zhong Lu1Zhen-Zhen Lu2Yi-Feng Yu3San-Gang Wu4Department of Radiation Oncology, Xiamen Cancer Quality Control Center, Xiamen Key Laboratory of Radiation Oncology, Xiamen Cancer Center, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen UniversityDepartment of Radiation Oncology, Xiamen Cancer Quality Control Center, Xiamen Key Laboratory of Radiation Oncology, Xiamen Cancer Center, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen UniversityThe School of Clinical Medicine, Fujian Medical UniversityDepartment of Radiation Oncology, Xiamen Cancer Quality Control Center, Xiamen Key Laboratory of Radiation Oncology, Xiamen Cancer Center, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen UniversityDepartment of Radiation Oncology, Xiamen Cancer Quality Control Center, Xiamen Key Laboratory of Radiation Oncology, Xiamen Cancer Center, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen UniversityAbstract Purpose To investigate the patterns of failure and prognosis in recurrent or metastatic nasopharyngeal carcinoma (rmNPC) according to Epstein-Barr virus-DNA (EBV-DNA) status. Methods We included NPC patients who were diagnosed with locoregional recurrence (LRR) and/(or) distant metastasis (DM) between January 2017 and June 2024. Receiver operating characteristic analysis, Chi-square test, Wilcoxon rank sum test, Kaplan-Meier method, and Multivariate Cox regression analyses were used for statistical analysis. Results This study involved 108 patients, including 105 (97.2%) who had EBV-DNA detectable at the initial diagnosis of NPC. Regarding progression patterns, 34 patients (31.5%) experienced only LRR, while 60 patients (55.6%) had only DM. LRR followed by DM was observed in 5 (4.6%) patients, DM followed by LRR occurred in 2 (1.8%) patients, and both LRR and DM were presented simultaneously in 7 (6.5%) patients. EBV-DNA positivity rates significantly differed between LRR and DM patients, at 76.9% and 97.1% respectively (P = 0.003). A significant difference was also observed in EBV-DNA levels, with a median level of 413 copies/mL for LRR and 6,550 copies/mL for DM (P < 0.001). While the EBV-DNA positivity rate did not differ significantly between oligometastatic disease and polymetastatic disease (P = 0.493), the levels were significantly elevated in the polymetastatic disease group than the oligometastatic disease group (P < 0.001). Multivariate analysis showed that liver metastasis (P = 0.012) and EBV-DNA levels ≥ 3,525 copies/mL at progression (P = 0.009) independently correlated with poorer overall survival. Conclusions Our study provides substantial evidence linking higher EBV-DNA levels with disease failure patterns and identifies liver metastasis and EBV-DNA levels at disease progression as independent prognostic factors for poorer overall survival in rmNPC patients.https://doi.org/10.1186/s13027-024-00631-1Nasopharyngeal carcinomaEBV-DNAFailure patternsOutcome |
| spellingShingle | Lin-Feng Guo Guan-Zhong Lu Zhen-Zhen Lu Yi-Feng Yu San-Gang Wu Patterns of failure and prognosis in nasopharyngeal carcinoma according to Epstein-Barr virus DNA status Infectious Agents and Cancer Nasopharyngeal carcinoma EBV-DNA Failure patterns Outcome |
| title | Patterns of failure and prognosis in nasopharyngeal carcinoma according to Epstein-Barr virus DNA status |
| title_full | Patterns of failure and prognosis in nasopharyngeal carcinoma according to Epstein-Barr virus DNA status |
| title_fullStr | Patterns of failure and prognosis in nasopharyngeal carcinoma according to Epstein-Barr virus DNA status |
| title_full_unstemmed | Patterns of failure and prognosis in nasopharyngeal carcinoma according to Epstein-Barr virus DNA status |
| title_short | Patterns of failure and prognosis in nasopharyngeal carcinoma according to Epstein-Barr virus DNA status |
| title_sort | patterns of failure and prognosis in nasopharyngeal carcinoma according to epstein barr virus dna status |
| topic | Nasopharyngeal carcinoma EBV-DNA Failure patterns Outcome |
| url | https://doi.org/10.1186/s13027-024-00631-1 |
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