Abstract
We investigated the value of pretreatment serum apolipoprotein A-I (ApoA-I) in complementing TNM staging in the prognosis of non-metastatic nasopharyngeal carcinoma (NPC). We retrospectively reviewed 1196 newly diagnosed patients with non-metastatic NPC. Disease-specific survival (DSS), distant metastasis-free survival (DMFS), and locoregional recurrence-free survival (LRFS) rates were compared according to serum ApoA-I level. Multivariate analysis was performed to assess the prognostic value of serum ApoA-I. The 5-year DSS, DMFS, and LRFS rates for patients with elevated or decreased serum ApoA-I were 81.3% versus 69.3% (P < 0.001), 83.4% versus 67.4% (P < 0.001), and 80.9% versus 67.3% (P < 0.001), respectively. ApoA-I ≥ 1.025 g/L was an independent prognostic factor for superior DSS, DMFS, and LRFS in multivariate analysis. After stratification by clinical stage, serum ApoA-I remained a clinically and statistically significant predictor of prognosis. Our data suggest that the level of ApoA-I at diagnosis is a novel independent prognostic marker that could complement clinical staging for risk definition in non-metastatic NPC.
Highlights
Nasopharyngeal carcinoma (NPC) is a unique malignancy with a remarkable geographic distribution, which occurs with much greater frequency in Southern China [1, 2]
We investigated the value of pretreatment serum apolipoprotein A-I (ApoA-I) in complementing TNM staging in the prognosis of non-metastatic nasopharyngeal carcinoma (NPC)
Our data suggest that the level of ApoA-I at diagnosis is a novel independent prognostic marker that could complement clinical staging for risk definition in non-metastatic NPC
Summary
Nasopharyngeal carcinoma (NPC) is a unique malignancy with a remarkable geographic distribution, which occurs with much greater frequency in Southern China [1, 2]. The recent reported incidence of NPC in Southern China is 30–80 per 100,000 people per year [3]. NPC is mostly radiosensitive, 20–30% of patients develop distant metastasis and/or recurrence despite of www.impactjournals.com/oncotarget treatment [4]. The prognosis for NPC patients is mainly based on TNM staging system. Patients with the same TNM stage and similar treatment regimens often present with variable clinical outcomes, suggesting that the present staging system is not adequate for prognosis. We investigated the value of pretreatment serum apolipoprotein A-I (ApoA-I) in complementing TNM staging in the prognosis of non-metastatic nasopharyngeal carcinoma (NPC)
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