Age at diagnosis indicated poor prognosis in locoregionally advanced nasopharyngeal carcinoma.

Effect of age at diagnosis on treatment failure and mortality was rarely evaluated in nasopharyngeal carcinoma.We analyzed 1252 patients staged III-IVb and underwent concurrent chemoradiotherapy. Age was categorized as 20 to 49 years (n=804), 50 to 59 years (n=282) and 60 years or older (n=166). Distant metastasis-free survival (DMFS), cancer-specific survival (CSS), overall survival (OS) and locoregional relapse-free survival (LRFS) were assessed by age group.The 4-years DMFS decreased with age group (86.7% [20-49 years], 86.7% [50-59 years], 77.1% [≥60 years]; P=0.014); likewise, 4-years CSS were 91.0%, 87.4% and 74.2% (P<0.001); 4-years OS were 90.8%, 87.4% and 73.6% (P<0.001), respectively. In multivariate analysis, compared with patients aged 20 to 49 years, DMFS decreased with age for patients aged 50 to 59 years (HR=1.10, 95% CI 0.77-1.57) and aged 60 years or older (HR=1.75, 95% CI 1.20-2.56) (P=0.015). Similarly, both CSS and OS were inferior in patients aged 50 to 59 years (HR=1.77, 95% CI 1.25-2.52 for CSS; HR=1.71, 95% CI 1.21-2.43 for OS) and aged 60 or older (HR=3.73, 95% CI 2.63-5.29 for CSS; HR=3.96, 95% CI 2.83-5.54 for OS) (P<0.001). Yet age did not affect LRFS in univariate and multivariate analysis.Increasing age at diagnosis of locoregionally advanced nasopharyngeal carcinoma was associated with higher risk of distant metastasis and mortality.