Abstract
BackgroundOver-expression of cyclooxygenase-2 (COX-2) enzyme has been reported in nasopharyngeal carcinoma (NPC). However, the prognostic significance of this has yet to be conclusively determined. Thus, from our randomized trial of radiation versus concurrent chemoradiation in endemic NPC, we analyzed a cohort of tumour samples collected from participants from one referral hospital.Methods58 out of 88 patients from this institution had samples available for analysis. COX-2 expression levels were stratified by immunohistochemistry, into negligible, weak, moderate and strong, and correlated with overall and disease specific survivals.Results58% had negligible or weak COX-2 expression, while 14% and 28% had moderate and strong expression respectively. Weak COX-2 expression conferred a poorer median overall survival, 1.3 years for weak versus 6.3 years for negligible, 7.8 years, strong and not reached for moderate. There was a similar trend for disease specific survival.ConclusionContrary to literature published on other malignancies, our findings seemed to indicate that over-expression of COX-2 confer a better prognosis in patients with endemic NPC. Larger studies are required to conclusively determine the significance of COX-2 expression in these patients.
Highlights
Nasopharyngeal carcinoma (NPC) is the sixth most common male cancer in Singapore
We hereby describe a retrospective analysis of 58 samples from patients, diagnosed with endemic nasopharyngeal carcinoma (NPC), who had previously been randomized into a trial of radiotherapy (RT) alone versus concurrent chemo-radiation (CRT) [7]
The aims of the study were to determine the expression level of COX-2 in our cohort of patients and to correlate this with known prognostic factors and overall and disease free survival. We thought the latter would be of particular interest given that studies pertaining to the prognostic significance of COX-2 expression in endemic NPC have so far delivered mixed results [8,9]
Summary
Nasopharyngeal carcinoma (NPC) is the sixth most common male cancer in Singapore. The current standard of care for locally advanced NPC is concurrent chemo-radiation, which is associated with increased acute and long term morbidities [1,2]. We hereby describe a retrospective analysis of 58 samples from patients, diagnosed with endemic NPC, who had previously been randomized into a trial of radiotherapy (RT) alone versus concurrent chemo-radiation (CRT) [7]. The aims of the study were to determine the expression level of COX-2 in our cohort of patients and to correlate this with known prognostic factors and overall and disease free survival. We thought the latter would be of particular interest given that studies pertaining to the prognostic significance of COX-2 expression in endemic NPC have so far delivered mixed results [8,9]. From our randomized trial of radiation versus concurrent chemoradiation in endemic NPC, we analyzed a cohort of tumour samples collected from participants from one referral hospital
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