Prognostic value of pretreatment and recovery duration of cranial nerve palsy in nasopharyngeal carcinoma

Abstract

Background: The purpose of this study was to evaluate the prognostic value of cranial nerve (CN) palsy in nasopharyngeal carcinoma (NPC) patients.

Methods: A retrospective analysis was performed on CN involvement using medical records of 178 consecutive patients with histologically diagnosed, non-disseminated NPC.

Results: In 178 NPC patients with CN palsy, the 5-year survival rates were as follows: overall survival (OS), 61.0%; disease-specific survival (DSS), 69.6%; local relapse-free survival (LRFS), 75.2%; distant metastasis-free survival (DMFS), 73.4%; and disease-free survival (DFS), 55.3%. Significant differences were observed in the 5-year OS rates between patients with single and multiple CN palsy (69.8% vs. 54.3%; P=0.033) and the OS rates between patients with different pretreatment durations (68.7% vs. 43.3%, P=0.007). However, no significant differences were observed in OS, DSS, LRFS and DFS rates between patients with upper and lower CN palsy (P=0.581, P=0.792, P=0.729 and P=0.212, respectively). The results showed that recovery duration was an independent prognostic factor for OS (HR=2.485; P<0.001), DSS (HR=2.065; P=0.016), LRFS (HR=3.051; P=0.001) and DFS (HR=2.440; P<0.001).

Conclusions: Recovery duration is an independent prognostic factor for NPC patients with CN palsy and is related to recurrence, which leads to poor survival. Recovery duration requires close surveillance and different treatment regimens.

Figure 1

The overall survival and disease-specific survival curves for the different numbers of CN palsy groups: Group 1, patients with single CN palsy; Group 2, patients with multiple CN palsy (A and B).

Figure 2

The overall survival and disease-specific survival curves for the different section groups: Group 1, patients with upper CN palsy; Group 2, patients with lower CN palsy (A and B).

Figure 3

The overall survival and disease-specific survival curves for the different pretreatment duration groups: Group 1, patients with CN palsy with a pretreatment duration within 2 months; Group 2, patients with a pretreatment duration beyond 2 months (A and B).

Figure 4

The overall survival, disease-specific survival, local relapse-free survival and disease-free survival curves for the different recovery duration groups: Group 1, recovery duration of patients with CN palsy within 6 months; Group 2, recovery duration beyond 6 months (A/B/C/D).