Prognosis of nasopharyngeal carcinoma in children and adolescents: a population-based analysis.

Objectives: The purpose of this study is to use a population-based cohort to examine the clinicopathological features and survival outcomes of nasopharyngeal cancer (NPC) in children and adolescents.

Methods: Demographic and clinicopathological variables of pediatric patients diagnosed with NPC were extracted from the Surveillance, Epidemiology, and End Results database (2000-2018). The survival rates were calculated using Kaplan-Meier analysis. Univariate survival analysis used the log-rank test, whereas multivariate analysis used Cox proportional-hazards regression to find factors impacting overall survival (OS).

Results: A total of 233 pediatric patients were analyzed, with a median age at diagnosis of 16 years (range: 7-19 years). The cancers primarily affected males (70.0%). In terms of grade, 8 (3.5%) patients were well and moderately differentiated, 31 (13.3%) patients were poorly differentiated, and 134 (57.5%) patients were undifferentiated. TNM stage and radiotherapy were significant independent predictors of overall survival. The risk of death was higher for M1 stage (hazard ratio (HR) 20.1, 95% confidence interval (CI), 8.0-50.5; P < 0.001) as compared to M0 stage. Furthermore, multivariate analysis revealed a significant survival advantage for radiotherapy treatment (HR 0.24, 95% CI, 0.09-0.68; P = 0.007).

Conclusion: NPC in children is rare and should be studied independently. This study found that TNM stage and radiotherapy were the most significant survival predictors, emphasizing the importance of these parameters in the prediction and treatment of pediatric NPC.

Level of evidence: 3: