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Review
. 2024 Nov;13(22):e70389.
doi: 10.1002/cam4.70389.

The Treatment of Primary Lymphoepithelioma-Like Carcinoma in the Head and Neck and Nasopharyngeal Carcinoma

Qiaohong Lin  1   2 , Mingyuan Du  1   2 , Shida Yan  1   2 , Xing Zhang  1   2 , Xiyuan Li  1   2 , Ying Zhang  1   2 , Shiting Zhang  1   2 , Shuwei Chen  1   2 , Ming Song  1   2
Affiliations
Review

The Treatment of Primary Lymphoepithelioma-Like Carcinoma in the Head and Neck and Nasopharyngeal Carcinoma

Qiaohong Lin et al. Cancer Med. 2024 Nov.

Erratum in

Abstract

Background: An uncommon cancer, lymphoepithelioma-like carcinoma (LELC) resembles undifferentiated nasopharyngeal carcinoma (NPC) histologically. The aim is mainly to introduce the diagnosis and treatment of LELC and compare it with NPC in our descriptive study.

Methods: A total of 278 patients with NPC and 157 patients with head and neck LELC had their medical records examined in this study. The propensity score matching (PSM) approach was employed to attain a 1:1 match between the LELC and NPC groups. Kaplan-Meier analysis was performed for overall survival (OS) of LELC and NPC. To determine their predictive values for OS, univariate and multivariate Cox regression analyses with significant survival differences (p < 0.05) were carried out.

Results: Similar to NPC, 107 (68.2%) LELC cases had Epstein-Barr virus (EBV) infection. LELC of the parotid glands was present in nearly 46.5% of patients with head and neck LELC. Most patients were treated with surgery with neck dissection. After PSM, LELC had similar 5-year OS rates to NPC (81.6% vs. 79.0%). LELC was less prone to distant metastasis compared to NPC. Age, T stage, N stage, and distant metastases were found to be substantially correlated with the outcome of LELC, according to the multivariate Cox regression analysis (p < 0.05).

Conclusions: EBV infection in the head and neck has been associated with LELC and NPC. When compared to NPC, LELC is more likely to arise in the salivary glands and has a lower incidence of distant metastasis. Surgery with neck dissection is the primary treatment for LELC.

Keywords: EBV infection; Lymphoepithelioma‐like carcinoma; nasopharyngeal carcinoma; prognosis; radiotherapy; surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Kaplan—Meier survival analyses to estimate OS for LELC in the head and neck (A) and NPC (A) patients after PSM. Kaplan—Meier survival analyses to estimate OS for LELC in the head and neck by age (B), T stage (C), N stage (D), and M stage (E). Kaplan—Meier survival analyses to estimate OS for NPC in the head and neck by N stage (F) and radiotherapy (G) in the whole set.
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