q ing liu, jinou chen, qihong huang, yanhua li cancer center, sun yat-sen university

中山大学肿瘤防治中心 SUN YAT-SEN UNIVERSITY CANCER CENTER

Trends in the survival of patients with nasopharyngeal carcinoma 1976-2005 in Sihui city, Guangdong province, P.R. of China: a population-based study

Qing Liu, Jinou Chen, Qihong Huang, Yanhua Li

Cancer Center, Sun Yat-sen University

Sihui Cancer Institute


NPC Epidemiological Charateristics in Sihui

Incidence rate of NPC: 30.9 in male and 13.0 in female

Mortality rate of NPC: 22.0 in male and 7.7 in female

Incidence rates and mortality rates of NPC kept stable

Comparing to the reduction in HK, TW, LA in USA


Trend of NPC incidence 1988-2002 in HK


Trend of NPC incidence 1978-2002 in Sihui

0

5

10

15

20

25

30

35

40

年份

(/10

)发

病率

万

men

women


Materials and methods

Cancer registry system since 1973 in Sihui

Follow up system for NPC cases since 1978

1761 incidence cases of NPC were chose during 1976-2005

Follow up to the end of 2006 , Max follow up year=30.4

1239 (70.3%) cases with pathological evidence



Kaplan–Meier estimate for survival rates

Cox proportional hazards regression for risk factor screening

Risk factors: gender,age,period of diagnosis,clinical stage, path

ological status,diagnosis medical unit were analyzed



Relative survival probabilities for NPC were assessed by match

ed sex, age group, period of diagnosis with general population

Age-specific death rates and life table of Sihui general populati

on was available based on death registry system

SURV3 was used for relative survival rate estimation

SAS 9.2 for other statistical analyses


Results


Characteristics of patients with NPC 1976-2005

Gender N %

Male 1189 67.5

Female 572 32.5

Age at diagnosis

<40 498 28.2

40- 545 30.9

50- 414 23.5

60+ 304 17.3



Clinical stage N %

I 107 6.1

II 546 31.0

III 467 26.5

IV 119 6.8

Unknown 522 29.6

Pathological diagnosis

WHO I 159 9.0

WHO II/III 1080 61.3

Unknown 522 29.6



Period diagnosed N %

1976- 409 23.2

1986- 472 26.8

1993- 534 30.3

2000- 346 19.6

Diagnostic hospital

CC 1076 61.1

Other 685 38.9


Five year survival of NPC patients in Sihui

MTS OS(95%CI) RS(95%CI)

All cases 5.1 50.5(48.1-52.9) 60.3(57.5-63.1)

Gender

Male 4.5 48.4(45.5-51.3) 59.3(55.8-62.8)

Female 6.2 54.5(50.4-58.7) 62.2(57.6-66.8)

Age at diagnosis

<40 8.7 56.4(51.9-60.9) 59.4(54.7-64.1)

40- 5.9 53.9(49.6-58.1) 60.1(55.4-64.8)

50- 4.8 48.7(43.8-53.6) 62.5(56.3-68.6)

60+ 2.8 36.4(30.8-41.9) 59.1(50.5-67.6)



MTS OS(95%CI) RS(95%CI)Clinical StagesI 14.4 73.7(65.3-82.1) 85.2(75.8-94.5)II 6.3 57.4(53.1-61.7) 69.4(64.5-74.3)III 2.8 38.3(33.8-42.8) 44.7(39.5-50.0)IV 2.3 31.5(22.8-40.2) 37.9(27.6-48.2)Unknown 6.1 52.8(48.4-57.2) 64.4(59.2-69.6)PathWHO I 5.1 49.8(41.1-58.6) 56.9(52.3-61.5)WHO II/III 5.5 52.1(49.1-55.1) 62.3(58.8-65.8)Unknown 4.2 46.4(42.0-50.9) 58.8(53.5-64.1)



MTS OS(95%CI) RS(95%CI)

Period diagnosed

1976-1985 3.8 42.5(37.8-47.3) 51.8(46.2-57.4)

1986-1992 4.0 43.4(39.0-47.9) 51.1(45.9-56.3)

1993-1999 5.5 52.1(47.8-56.3) 62.5(57.5-67.6)

2000-2005 - 69.8(64.1-75.4) 84.8(79.1-90.6)

Diagnostic Hospital

CC 5.5 52.3(49.3-55.3) 62.3(58.8-65.8)

Others 4.3 47.4(43.5-51.2) 56.9(52.3-61.5)


Risk factors related to death from NPC by Multivariate Cox Regression HR 95%CI

Gender Male 1.00Female 0.76 0.65-0.90

Age <40 1.0040- 1.21 0.99-1.4950- 1.51 1.22-1.8860+ 2.22 1.73-2.84

Stage I 1.00II 1.61 1.17-2.22III 2.61 1.89-3.60IV 3.41 2.34-4.99

Histo WHOII/III 1.00WHO I 1.28 1.00-1.64

Period 1976-1985 1.001986-1992 0.76 0.63-0.911993-1999 0.55 0.45-0.682000-2005 0.28 0.20-0.40


Observed and relative survival (95%CI) of NPC in Sihui 1976-2005

0 2 4 6 8 100.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

year after diagnosis

OSR RSR


Relative survival of NPC, stage I and II


Relative survival of NPC, stage III and IV


Conclusion

Significant improvement of NPC survival

No change of proportion of stage of NPC cases

Improved radiotherapy might contribute to survival of NPC

Screening for NPC will definitely increase survival of NPC

May predict a reduction of mortality rates of NPC in Sihui


screening

q ing liu, jinou chen, qihong huang, yanhua li cancer center, sun yat-sen university

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