Lin-Feng Guo,* Ya-Qing Dai,* Yi-Feng Yu, San-Gang Wu

Department of Radiation Oncology, Xiamen Cancer Quality Control Center, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yi-Feng Yu; San-Gang Wu, Department of Radiation Oncology, Xiamen Cancer Quality Control Center, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, People’s Republic of China, Email yuyfeng001@sina.com; wusg@xmu.edu.cn

Purpose: To investigate the prognostic implications of gender in nasopharyngeal carcinoma (NPC) utilizing data from two independent cohorts: the Xiamen (XM)-NPC cohort (an endemic area in China) and the United States Surveillance, Epidemiology, and End Results (SEER)-NPC cohort (a non-endemic area).
Methods: We included patients diagnosed with NPC from both the XM-NPC and SEER-NPC cohorts. Statistical analysis involved the chi-square test, Kaplan-Meier method, and multivariate Cox regression analyses.
Results: The study identified 728 patients in the XM-NPC cohort and 2237 in the SEER cohort. In the XM-NPC cohort, 515 (70.7%) were male and 213 (29.3%) were female. In the SEER-NPC cohort, 1597 (71.4%) were male and 640 (28.6%) were female. The male-to-female ratio peaked at ≤ 25 years (2.33) and 46– 55 years (2.79) in the XM-NPC cohort, and at ≤ 25 years (2.07) and 56– 65 years (3.24) in the SEER-NPC cohort. The lowest ratios were observed among patients aged 26– 35 years in both cohorts (XM-NPC: 1.64; SEER-NPC:1.38). In the XM-NPC cohort, females had significantly better overall survival (P=0.022) and distant metastasis-free survival (P=0.038) compared to males. Similarly, in the SEER-NPC cohort, gender was found to be an independent prognostic factor for overall survival, with females showing better outcomes (P=0.038). Consistent trends were observed in patients aged > 45 years in both cohorts, while survival outcomes were comparable between genders in patients aged ≤ 45 years.
Conclusion: Gender independently influences survival outcomes of NPC in both endemic and non-endemic areas.

Keywords: nasopharyngeal carcinoma, gender, SEER, Chinese, outcome