Our study is to assess the prognosis of neck residue NPC patients and the efficacy of radical neck dissection in the treatment of these patients.
68 neck residue NPC patients were recruited. Each neck residue patient was matched to another three patients, adjusting for age(Â±5 years), gender, pathological type, T'N'M stage, RT technique and type of treatment from the same institute and time period of therapy (Â± 18 months). The primary endpoint was progression-free survival (PFS). Secondary endpoints were overall survival (OS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRRFS). The Cox proportional hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) and in multivariable analysis to test the independent statistical significance of NPC patients. All statistical tests were two-sided.
With a median follow-up of 44 months, residual group significantly decreased the 3-year PFS rate(87.6% vs. 46.7%; HR of progression = 6.09, 95% CI = 3.66 to 10.14; P < 0.001), OS(92.8% vs. 85.3%; HR of death = 3.536, 95% CI = 1.78 to 7.04; P < 0.001), distant metastasis-free survival ( 90.4% vs.77.6%; HR of distant relapse = 3.21, 95% CI = 1.70 to 6.05; P < 0.001) and locoregional relapse-free survival rate (97.1% vs.54.1%; HR of locoregional relapse = 18.93, 95% CI = 8.19 to 43.78; P < 0.001). Multivariable analysis showed that neck residue was still an independent prognostic factor for PFS, OS, DMFS and LRRFS, respectively, after adjusting for other risk factors.
Neck residue after completely treatment was associated with poor prognosis for NPC patients. In addition of management of radical neck dissection, more intensive treatment should be provided for the patients with neck residue after completely chemoradiotherapy.
Clinical trial identification
All authors have declared no conflicts of interest.