Prognostic Value of Skull Base Foramen Invasion Subclassification in T Category Modification and Induction Chemotherapy Management for Nasopharyngeal Carcinoma: Post‐Hoc Analysis of a Dual‐Center Retrospective Cohort Study
Abstract Skull base foramen invasion (SBFI) indicates poor prognosis in nasopharyngeal carcinoma (NPC). However, only a few studies systematically assessed the role of SBFIin staging and treatment of NPC. To investigate the prognostic value of SBFI in NPC, a total of 1,752 patients with nonmetastati...
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2025-01-01
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| Series: | Advanced Science |
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| Online Access: | https://doi.org/10.1002/advs.202408182 |
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| author | Siyu Zhu Shuqi Li Di Cao Chao Luo Zhiying Liang Shaobo Liang Guoyi Zhang Qin Zhao Guangying Ruan Lizhi Liu Gui Fu Haojiang Li |
| author_facet | Siyu Zhu Shuqi Li Di Cao Chao Luo Zhiying Liang Shaobo Liang Guoyi Zhang Qin Zhao Guangying Ruan Lizhi Liu Gui Fu Haojiang Li |
| author_sort | Siyu Zhu |
| collection | DOAJ |
| description | Abstract Skull base foramen invasion (SBFI) indicates poor prognosis in nasopharyngeal carcinoma (NPC). However, only a few studies systematically assessed the role of SBFIin staging and treatment of NPC. To investigate the prognostic value of SBFI in NPC, a total of 1,752 patients with nonmetastatic NPC from two hospitals (1,320 and 432) between January 2010 and March 2014 are enrolled. The primary endpoint is overall survival (OS). Heatmap/cluster and network analyses are used to provide subclassification indication. Univariate and multivariate analyses with Kaplan–Meier method are performed to compare survival outcomes. SBFIs are classified into slight (only foramen lacerum and/or pterygopalatine fossa invasion) and severe (other SBFIs). The severe SBFI is an unfavorable prognosticator for OS in both the entire cohort and the T3 group. OS is similar between T3 with severe SBFI and T4 patients. Reclassifying T3 with severe SBFI as the T4 category yields an improved T category discrimination. Additionally, patients in the severe SBFI group gain significant survival benefits from induction chemotherapy ((IC). Therefore, T3 NPC with severe SBFI is an independent negative predictor for OS and is classified into the T4 category. T category adjustment enables better prognostic stratification. Severe SBFI benefits from IC in long‐term OS. |
| format | Article |
| id | doaj-art-4a62d502742144daa151f9ad293eb7c4 |
| institution | Kabale University |
| issn | 2198-3844 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| series | Advanced Science |
| spelling | doaj-art-4a62d502742144daa151f9ad293eb7c42025-01-29T09:50:19ZengWileyAdvanced Science2198-38442025-01-01124n/an/a10.1002/advs.202408182Prognostic Value of Skull Base Foramen Invasion Subclassification in T Category Modification and Induction Chemotherapy Management for Nasopharyngeal Carcinoma: Post‐Hoc Analysis of a Dual‐Center Retrospective Cohort StudySiyu Zhu0Shuqi Li1Di Cao2Chao Luo3Zhiying Liang4Shaobo Liang5Guoyi Zhang6Qin Zhao7Guangying Ruan8Lizhi Liu9Gui Fu10Haojiang Li11Department of Radiology State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou 510060 P. R. ChinaDepartment of Radiology State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou 510060 P. R. ChinaDepartment of Radiology State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou 510060 P. R. ChinaDepartment of Radiology State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou 510060 P. R. ChinaDepartment of Radiology State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou 510060 P. R. ChinaDepartment of Radiation Oncology Foshan Academy of Medical Sciences Sun Yat‐Sen University Foshan Hospital and The First People's Hospital of Foshan Foshan 528000 P. R. ChinaDepartment of Radiation Oncology Foshan Academy of Medical Sciences Sun Yat‐Sen University Foshan Hospital and The First People's Hospital of Foshan Foshan 528000 P. R. ChinaDepartment of Radiology State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou 510060 P. R. ChinaDepartment of Radiology State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou 510060 P. R. ChinaDepartment of Radiology State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou 510060 P. R. ChinaDepartment of Radiology State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou 510060 P. R. ChinaDepartment of Radiology State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou 510060 P. R. ChinaAbstract Skull base foramen invasion (SBFI) indicates poor prognosis in nasopharyngeal carcinoma (NPC). However, only a few studies systematically assessed the role of SBFIin staging and treatment of NPC. To investigate the prognostic value of SBFI in NPC, a total of 1,752 patients with nonmetastatic NPC from two hospitals (1,320 and 432) between January 2010 and March 2014 are enrolled. The primary endpoint is overall survival (OS). Heatmap/cluster and network analyses are used to provide subclassification indication. Univariate and multivariate analyses with Kaplan–Meier method are performed to compare survival outcomes. SBFIs are classified into slight (only foramen lacerum and/or pterygopalatine fossa invasion) and severe (other SBFIs). The severe SBFI is an unfavorable prognosticator for OS in both the entire cohort and the T3 group. OS is similar between T3 with severe SBFI and T4 patients. Reclassifying T3 with severe SBFI as the T4 category yields an improved T category discrimination. Additionally, patients in the severe SBFI group gain significant survival benefits from induction chemotherapy ((IC). Therefore, T3 NPC with severe SBFI is an independent negative predictor for OS and is classified into the T4 category. T category adjustment enables better prognostic stratification. Severe SBFI benefits from IC in long‐term OS.https://doi.org/10.1002/advs.202408182category modificationnasopharyngeal carcinomaskull base foramen invasiontreatment management |
| spellingShingle | Siyu Zhu Shuqi Li Di Cao Chao Luo Zhiying Liang Shaobo Liang Guoyi Zhang Qin Zhao Guangying Ruan Lizhi Liu Gui Fu Haojiang Li Prognostic Value of Skull Base Foramen Invasion Subclassification in T Category Modification and Induction Chemotherapy Management for Nasopharyngeal Carcinoma: Post‐Hoc Analysis of a Dual‐Center Retrospective Cohort Study Advanced Science category modification nasopharyngeal carcinoma skull base foramen invasion treatment management |
| title | Prognostic Value of Skull Base Foramen Invasion Subclassification in T Category Modification and Induction Chemotherapy Management for Nasopharyngeal Carcinoma: Post‐Hoc Analysis of a Dual‐Center Retrospective Cohort Study |
| title_full | Prognostic Value of Skull Base Foramen Invasion Subclassification in T Category Modification and Induction Chemotherapy Management for Nasopharyngeal Carcinoma: Post‐Hoc Analysis of a Dual‐Center Retrospective Cohort Study |
| title_fullStr | Prognostic Value of Skull Base Foramen Invasion Subclassification in T Category Modification and Induction Chemotherapy Management for Nasopharyngeal Carcinoma: Post‐Hoc Analysis of a Dual‐Center Retrospective Cohort Study |
| title_full_unstemmed | Prognostic Value of Skull Base Foramen Invasion Subclassification in T Category Modification and Induction Chemotherapy Management for Nasopharyngeal Carcinoma: Post‐Hoc Analysis of a Dual‐Center Retrospective Cohort Study |
| title_short | Prognostic Value of Skull Base Foramen Invasion Subclassification in T Category Modification and Induction Chemotherapy Management for Nasopharyngeal Carcinoma: Post‐Hoc Analysis of a Dual‐Center Retrospective Cohort Study |
| title_sort | prognostic value of skull base foramen invasion subclassification in t category modification and induction chemotherapy management for nasopharyngeal carcinoma post hoc analysis of a dual center retrospective cohort study |
| topic | category modification nasopharyngeal carcinoma skull base foramen invasion treatment management |
| url | https://doi.org/10.1002/advs.202408182 |
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