Primary tumour volume: Important predictor of outcome for T3- and T4-staged nasopharyngeal carcinoma

Objective: To investigate the relationship between primary turnout volumes and treatment outcomes within T3- and T4-staged nasopharyngeal carcinoma. Design: Retrospective study. Setting: Tertiary care centre. Methods: Forty newly diagnosed T3-staged patients and 36 newly diagnosed T4-staged patients participated in the study. Main Outcome Measures: Computed tomography-derived primary turnout volume was obtained from the summation of areas technique. The probabilities of achieving turnout control and patient survival were estimated using the product-limit method of Kaplan and Meier. The log rank test was used to examine significance. Results: In T3-staged nasopharyngeal carcinoma, the median primary turnout volume was 29.6 mL, with a range from 8.0 to 131.8 mL. After segregating the primary turnout volume into two subgroups (< 30 mL, > 30 mL), large primary turnout volume was associated with a significantly poorer disease-specific survival (p = .0001). In T4-staged cases, the median primary turnout volume was 54.07 mL, with a range from 6.7 to 223.1 mL. After segregating the primary turnout volume into two subgroups (< 60 mL, > 60 mL), larger primary tumour volume was associated with a significantly poorer disease-specific survival (p = .0022). Conclusion: Within the same T3- and T4-staged nasopharyngeal carcinoma, the primary turnout volume represented an important prognostic factor. To improve the treatment outcome of T3- and T4-staged nasopharyngeal carcinoma with large primary turnout volumes, more aggressive treatment is needed.