A large-scale retrospective study of the overall survival outcome in nasopharyngeal carcinoma with hypertension in Chinese population

// Pei Yang 1,2 , Hesham Elhalawani 2 , Yingrui Shi 1 , Ying Tang 3,1 , Yaqian Han 1 , Yu Zhao 1,2 , Fan Lou 1 and Hekun Jin 1 1 Department of Head and Neck Radiation Oncology, Hunan Cancer Hospital, Changsha, Hunan, China 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA 3 Department of Chinese Traditional Medicine, The Jishou Chinese Traditional Medicine Hospital, Jishou, Hunan, China Correspondence to: Hekun Jin, email: // Keywords : VEGF, NPC, hypertension, radiation theropy, hypoxia Received : March 06, 2017 Accepted : April 15, 2017 Published : April 27, 2017 Abstract Background: It is known that hypertension is associated with high levels of vascular endothelial growth factor (VEGF) expression which is, in turn, highly connected to the prognosis of a wide array of cancers. The purpose of this study was to evaluate the relationship between hypertension and prognosis of nasopharyngeal carcinoma (NPC) with definitive radiotherapy in a Chinese population. Patients and Methods: We retrospectively reviewed 4493 patients with NPC who received definitive radiotherapy from 1995 to 2006, with a minimum follow-up of 5 years. Kaplan-Meier survival analysis and Cox proportional hazard model were utilized to determine the association between hypertension and overall survival (OS). Results: A total of 802 patients with NPC suffered from hypertension as compared to 3691 patients with no associated hypertension. Kaplan-Meier analysis revealed median overall survival of 101.1 and 110.0 months, respectively ( p <0.05). In univariate survival analysis, patients with hypertension had worse OS ( p <0.05) than non-hypertension patients. Patients with higher grade hypertension also had worse OS ( p <0.05) compare to patients with grade 1 hypertension. In multivariate survival analysis, patients with hypertension had significantly worse OS ( p <0.05) than non-hypertension patients, as well as M stage ( p <0.001), after adjustment for related clinical confounding factors. Conclusion: Our findings provide evidence that hypertension is an independent factor and result in poorer survival outcomes in patients with NPC, the mechanism is still unclear, and it worth further research.