Short-term OS as a surrogate endpoint for 5-year OS in nasopharyngeal carcinoma in non-endemic area

World J Surg Oncol. 2024 Jul 11;22(1):180. doi: 10.1186/s12957-024-03460-z.

Abstract

Purpose: To address this evidence gap and validate short-term OS at less than 5 years as a reliable surrogate endpoint for 5-year OS.

Methods: We analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database, focusing on non-metastatic NPC patients diagnosed between 2010 and 2015. Patients were categorized into radiotherapy and chemoradiotherapy groups.

Results: This retrospective study examined 2,047 non-metastatic NPC patients. Among them, 217 received radiotherapy, and 1,830 received chemoradiotherapy. Our analysis results indicated that the 4-year OS may serve as a reliable surrogate endpoint for patients with AJCC clinical stage I (80 vs. 78%, P = 0.250), regardless of the treatment received. Specifically, in the radiotherapy group, patients with stage I, T0-T1, and N0 NPC showed similar OS rates at 4 and 5 years (83 vs. 82%, P = 1.000; 78 vs. 76%, P = 0.250; 78 vs. 77%, P = 0.500, respectively). Similarly, patients with stage II-IV, T2-T4, and N1-3 NPC showed no significant difference in OS rates between 3 and 5 years (57 vs. 51%, P = 0.063; 52 vs. 46%, P = 0.250; 54 vs. 46%, P = 0.125, respectively) in the radiotherapy group. In the chemoradiotherapy group, only the 3-year OS rate did not significantly differ from that at 5 years in stage I patients (79vs. 72%, P = 0.063).

Conclusions: Our study suggests that short-term surrogate endpoints may be valuable for evaluating 5-year OS outcomes in NPC patients in non-endemic areas.

Keywords: Nasopharyngeal carcinoma; Overall survival; SEER; Short-term endpoints; Surrogate endpoint.

MeSH terms

  • Adult
  • Aged
  • Chemoradiotherapy* / methods
  • Chemoradiotherapy* / mortality
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Nasopharyngeal Carcinoma* / mortality
  • Nasopharyngeal Carcinoma* / pathology
  • Nasopharyngeal Carcinoma* / therapy
  • Nasopharyngeal Neoplasms* / mortality
  • Nasopharyngeal Neoplasms* / pathology
  • Nasopharyngeal Neoplasms* / therapy
  • Neoplasm Staging*
  • Prognosis
  • Retrospective Studies
  • SEER Program / statistics & numerical data
  • Survival Rate
  • Young Adult