Analysis of Prognostic Factors for Internal Carotid Artery Invasion by Nasopharyngeal Carcinoma
by
, , , and
Ching-Feng Lien
1,2, 
Shyh-An Yeh
2,3,
Chiu-Shih Cheng
4,
Feng-Yu Chiang
1,2,
Tzer-Zen Hwang
1,5,
Bi-He Cai
2
,
Chih-Yi Liu
6,
Hsu-Huei Weng
7,
Chia-Chi Chen
8
and
Meng-Che Hsieh
5,9,* 1
Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
2
School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
3
Department of Radiation Oncology, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
4
Department of Neuroradiology, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
5
School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
6
Nursing Department, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
7
Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Chang Gung University College of Medicine, Taoyuan City 33302, Taiwan
8
Department of Pathology, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
9
Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
*
Author to whom correspondence should be addressed.
Cancers 2025, 17(3), 488; https://doi.org/10.3390/cancers17030488
Submission received: 9 January 2025
/
Revised: 26 January 2025
/
Accepted: 27 January 2025
/
Published: 1 February 2025
(This article belongs to the Section Cancer Survivorship and Quality of Life)
Simple Summary
Our study aimed to analyze prognostic factors for internal carotid artery (ICA) invasion by nasopharyngeal cancer. Our results demonstrated that the ICA invasion group showed a worse prognosis compared to the no ICA invasion group. Multivariate analysis identified that the neutrophil–lymphocyte ratio (NLR) was an independently prognostic factor for overall survival and for disease-specific survival. Hence, we concluded that locally advanced NPC patients with ICA invasion have a miserable outcome and NLR represents a significant prognostic factor that impacts treatment decisions and survival.
Abstract
Background: The prognostic impact of internal carotid artery (ICA) invasion in nasopharyngeal cancer (NPC) patients is not well established. Thus, we conducted a retrospective study to analyze the prognostic factors for ICA invasion by NPC. Methods: This retrospective study included consecutive biopsy-proven NPC patients who received CCRT from November 2015 to December 2022 at E-Da Hospital. Patients were then classified into two groups according to ICA invasion by tumor or not. Survival was estimated by the Kaplan–Meier method with a five-year overall survival (OS) rate and five-year disease specific survival (DSS) rate. Results: A total of 191 patients with pathologically confirmed NPC were included in this study, with 54 patients in the ICA invasion group and 137 patients in the no ICA invasion group. The ICA invasion group showed a worse prognosis compared to the no ICA invasion group (p < 0.001 in OS and DSS). Patients were stratified into a poor response group and good response group. OS and DSS in the poor response group had a significant difference compared to the good response group (both p < 0.001). In multivariate analysis, NLR was an independently prognostic factor for OS (HR 2.430, 95% CI 1.040–5.678, p = 0.040 and HR 0.412, 95% CI 0.176–0.962, p = 0.040, respectively) and for DSS (HR 2.430, 95% CI 1.040–5.678, p = 0.040 and HR 0.412, 95% CI 0.176–0.962, p = 0.040, respectively). Conclusions: Locally advanced NPC patients with ICA invasion have a miserable outcome and NLR represents a significant prognostic factor that impacts treatment decisions and survival.
