Prognostic factors and treatment outcomes in nasopharyngeal carcinoma patients with liver metastasis

OBJECTIVE: To explore the risk factors for liver metastasis (LM) in patients with nasopharyngeal carcinoma (NPC) and to compare the long-term survival outcomes between surgical resection and transcatheter arterial chemoembolization (TACE) in patients who developed LM. METHODS: A retrospective analysis was conducted on 98 patients with NPC treated at our hospital between January 2021 and March 2025. Patients were stratified into an LM group (n = 38) and a non-LM group (n = 60). Univariate and multivariate logistic regression analyses were performed to identify factors associated with LM. Among LM patients, long-term survival was compared between those undergoing partial hepatectomy (n = 20) and those treated with TACE (n = 18). RESULTS: No significant differences were observed between the LM and non-LM groups in terms of age, BMI, tumor size, GPS score, KPS score, ALT level, or comorbidities (all P > 0.05). However, significant differences were found in gender (male: 73.7% vs. 50.0%, P = 0.026), TNM stage (stage III: 65.8% vs. 31.7%, P < 0.01), AST level (42.6 ± 18.3 U/L vs. 28.4 ± 12.1 U/L, P = 0.003), chemotherapy usage (57.9% vs. 85.0%, P = 0.004), and HBsAg positivity (34.2% vs. 11.7%, P = 0.008). Multivariate analysis identified male gender (OR = 2.45, 95% CI: 1.12-5.36), TNM stage III (OR = 3.82, 95% CI: 1.75-8.35), elevated AST (OR = 1.04 per U/L, 95% CI: 1.01-1.07), absence of chemotherapy (OR = 3.12, 95% CI: 1.42-6.85), and HBsAg positivity (OR = 3.58, 95% CI: 1.52-8.41) as independent risk factors for LM. Among LM patients, the 3-year overall survival rate was significantly higher in the hepatectomy group compared to the TACE group (65.0% vs. 33.3%, log-rank P = 0.021).