Patient Characteristics and Treatment Outcomes of Nasopharyngeal Carcinoma in Nonendemic Regions

Abstract

Importance: Nasopharyngeal carcinoma (NPC) presents unique challenges in nonendemic regions, with varying patient characteristics and outcomes compared with endemic populations. Objective: To fill gaps in the current understanding of NPC by focusing on a US population, comparing patient characteristics and treatment outcomes with endemic populations, and identifying key factors to inform management and follow-up protocols in Western health care settings. Design, Setting, and Participants: This retrospective cohort study included patients with NPC treated at a single large US tertiary academic medical center from 2000 to 2023. The study analyzed patient demographics, tumor characteristics, treatment modalities, and survival outcomes. Data were analyzed from January to July 2024. Main Outcomes and Measures: Overall survival (OS), progression-free survival (PFS), and recurrence-free survival, stratified by patient characteristics, tumor types, Epstein-Barr virus (EBV) status, and p16 expression. Results: The sample included 159 adult patients with NPC (median [range] age, 53.5 [18-90] years; 117 [73.6%] male), with 23 African American patients (15.3%), 21 Asian patients (14.0%), and 106 White patients (70.7%). World Health Organization type III tumors predominated (88 patients [68.8%]), followed by type II (25 patients [19.5%]) and type I (15 patients [11.7%]). EBV positivity rates varied significantly by race (Asian: 13 patients [81.3%]; African American: 17 patients [63.0%]; White: 40 patients [47.0%]; P =.03) and WHO type (type III: 50 patients [72.5%]; type II: 10 patients [48.0%]; type I: 0 patients; P