Prognosis and survival for nasopharyngeal cancer
If you have nasopharyngeal cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person (such as whether they smoke) that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for nasopharyngeal cancer.
The stage is the most important prognostic factor for nasopharyngeal cancer. The lower the stage, the better the prognosis. Unfortunately most nasopharyngeal cancers are found at a later stage, when the cancer has spread to lymph nodes or distant organs.
Size of the tumour @(Model.HeadingTag)>
The size of the tumour is usually related to the stage of nasopharyngeal cancer. The higher the stage, the larger the tumour. Smaller tumours (less than 2 cm) have a better prognosis than larger tumours.
Spread to lymph nodes @(Model.HeadingTag)>
Nasopharyngeal cancer that has spread to the lymph nodes in the neck (cervical lymph nodes) has a poorer prognosis.
If nasopharyngeal cancer has spread to the lymph nodes in the lower areas of the neck, the prognosis is also poorer. This makes it likely that the nasopharyngeal cancer has also spread to distant organs.
Type of tumour @(Model.HeadingTag)>
Non-keratinizing squamous cell carcinoma has a better prognosis than other types of nasopharyngeal cancer.
Epstein-Barr virus @(Model.HeadingTag)>
A high level of Epstein-Barr virus (EBV) antibodies in the blood after treatment indicates a poorer prognosis.
Margin status @(Model.HeadingTag)>
The margin is the area of healthy tissue around a tumour that is removed along with the tumour during surgery. If there are cancer cells in the margin, it is called a positive surgical margin. If cancer cells are not found in the margin, it is called a negative margin. Tumours with negative surgical margins have a better prognosis.
People who are under 60 tend to have a better prognosis than people who are over 60.
Other health problems @(Model.HeadingTag)>
People who have other health problems, such as heart or lung disease, have a poorer prognosis. These other health issues are called comorbidities.
Hu K, Chan A, Costantino P, Harrison L . Cancer of the nasopharynx: General principles and management. Harrison LB, Sessions RB, Kies MS (eds.). Head and Neck Cancer: A Multidisciplinary Approach. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014: 22A: 588 - 617.
Kim S, Smith BD and Haffty BG . Prognostic factors in patients with head and neck cancer. Harrison LB, Sessions RB, Kies MS (eds.). Head and Neck Cancer: A Multidisciplinary Approach. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014: 3: 87-111.
National Cancer Institute. Nasopharyngeal Cancer Treatment (PDQ®) Health Professional Version. 2015: https://www.cancer.gov/types/head-and-neck/hp/nasopharyngeal-treatment-pdq#section/all.
Wenig BM, Cohen JM . General principles of head and neck pathology. Harrison LB, Sessions RB, Kies MS (eds.). Head and Neck Cancer: A Multidisciplinary Approach. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014: 1: 2 - 76.