2Department of Radiation Oncology, Recep Tayyip Erdoğan University Rize Training and Research Hospital, Rize-Türkiye
3Department of Pathology, Necmettin Erbakan University Faculty of Medicine, Konya-Türkiye
4Department of Pathology, Meram Public Hospital, Konya-Türkiye DOI : 10.5505/tjo.2026.4731 OBJECTIVE
Nasopharyngeal cancer (NPC) is highly treatment-sensitive, yet distant metastasis remains a challenge. Data on adjuvan therapy needs in non-metastatic (NM) cases from non-endemic regions (NERs) are limited. This retrospective cohort analysis aimed to evaluate the prognostic impact of PD-L1 and Tumor Proportion Score (TPS) in NM NPC patients from a NER.
METHODS
We retrospectively analyzed PD-L1 expression in tumor samples of patients with locoregionally confined
NPC. TPS, derived from PD-L1 expression, was correlated with clinical outcomes. Data were analyzed
using SPSS 26 with t-tests and chi-square tests for group comparisons, Kaplan?Meier, and Cox
regression analyses for survival assessment.
RESULTS
The study included 60 patients with a mean follow-up of 114.5 months. The TPS expression stratified
into two groups as <43 (n=24), and ?43 (n=36). Statistically significant differences were observed in
treatment response across the TPS subgroups (p<0.05). TPS?43 was associated with significantly longer
overall survival compared to lower TPS expression (p<0.05).
CONCLUSION
TPS expression ?43 was significantly associated with longer survival and better treatment response in NM
NPC. These findings support the use of TPS as a prognostic biomarker, which could guide clinical adjuvant
treatment studies that improve survival rates and treatment effectiveness. These results underscore the significance
of ongoing research and the development of personalized treatment plans for NM NPC patients.