Abstract
The prognostic value of serum alkaline phosphatase (S-ALP) has not been fully validated for nasopharyngeal carcinoma (NPC). S-ALP levels were measured in 601 patients newly diagnosed with NPC before radical treatment, and possible associations of these levels with 5-year overall survival (OS) and tumor-free survival (TFS) were explored using univariate and multivariate analyses. Elevated pretreatment S-ALP (>85 U/L) was significantly less frequent among patients classified as T1+2 or stage I+II than among those classified as T3+4 or stage III+IV. Multivariate analysis showed that elevated pretreatment S-ALP (>85 U/L), age, T classification and N stage were independent predictors of poor OS and TFS. Pretreatment S-ALP may be a reliable biomarker to evaluate the long-term prognosis of patients with NPC.
Highlights
Nasopharyngeal carcinoma (NPC) is common in southern China, and Guangdong and Guangxi province are the largest continuous endemic areas
Of these 693 patients, 92 (13.3%) were excluded for failing to fulfill the inclusion criteria, comprising 30 (4.3%) who showed evidence of distant metastasis, 29 (4.2%) who did not receive complete radical treatment, 14 (2.0%) who received radiotherapy or chemotherapy before blood was drawn for serum alkaline phosphatase (S-ALP) measurement, 4 (0.58%) who had secondary malignant tumors at the time of diagnosis, 2 (0.3%) who were histologically diagnosed with type I
S-ALP has been reported to be a sensitive indicator for diagnosis and recurrence monitoring of some malignant cancers ( Wei et al, 1993; Crivellari et al, 1995), but one study suggested it would be inappropriate for nasopharyngeal carcinoma (NPC) diagnosis because of the low percentage of patients with abnormally high S-ALP (>110 U/L) (Li et al, 2012)
Summary
Nasopharyngeal carcinoma (NPC) is common in southern China, and Guangdong and Guangxi province are the largest continuous endemic areas In these areas, NPC occurs with an incidence up to 20-30/100, 000 per year (Yu et al, 2002), accounting for approximately 50% of the 80, 000 cases newly diagnosed each year around the world (Wildeman et al, 2012). The survival rate has significantly improved as these procedures have advanced, approximately 50% of NPC patients experience recurrence, especially patients with late-stage disease (Huncharek et al, 2002; Teo et al, 2002). This highlights the need for accurate evaluation of NPC prognosis. Conclusions: Pretreatment S-ALP may be a reliable biomarker to evaluate the long-term prognosis of patients with NPC.
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