Abstract
PURPOSE: There are few studies on early-onset and late-onset nasopharyngeal cancer (EONPC and LONPC, defined as cancers in those aged < 50 and ≥ 50 years, respectively). This study aimed to determine the clinical and survival characteristics of patients with NPC in these two age groups. METHODS: This study involved patients diagnosed with NPC between 2000 and 2018, as per the Surveillance, Epidemiology, and End Results (SEER) database, and in our institution from 2014 to 2017. The clinicopathological characteristics, treatment modalities, and survival outcomes of patients with EONPC and LONPC were analyzed and compared. RESULTS: A total of 2943 patients from the SEER database and 833 domestic patients from our center were enrolled in the study. The EONPC group showed a better prognosis than LONPC (p < 0.001), despite a worse staging of regional lymph node metastasis (p < 0.001). Similar results were validated at our center; further, patients with EONPC presented more EBV-DNA positive rates (58% vs. 36.8%, p < 0.001) than those with LONPC. Further, the EONPC group had a superior overall survival (OS) (p = 0.017) and cancer-specific survival (CSS) (p = 0.004) compared to that of the LONPC patients. Univariate and multivariate Cox regression analyses revealed EONPC to be independently associated with a higher five-year OS. CONCLUSIONS: Though the EONPC group presented with more advanced clinical stages and lymph node metastasis, they showed better survival than the LONPC group. Age ≤ 50 years was an independent prognostic factor for survival outcomes in patients with NPC. Further studies on EONPC are warranted to achieve a better individualized therapeutic regimen.