Background:Nasopharyngeal carcinoma (NPC) is a malignancy with distinct geographical distribution and varying prognostic factors. Understanding the impact of various clinical and demographic factors on survival outcomes is crucial for optimizing treatment strategies. Methods:A retrospective analysis was conducted using data from 6,560 NPC patients obtained from the SEER database. Patients were categorized based on the AJCC 6th edition staging, race, age, marital status, histologic type, tumor size, and treatment modalities. Univariate and multivariate analyses were performed to identify significant prognostic factors for overall survival (OS) and cause-specific survival (CSS). Kaplan-Meier survival curves and log-rank tests were utilized to compare survival differences among subgroups. Results:The study revealed significant differences in survival outcomes based on the AJCC 6th edition metastasis classification. Patients with M0 status had substantially higher OS and CSS compared to those with M1 status (p < 0.0001). Age was a significant prognostic factor, with patients aged 60 years and above having a significantly higher mortality risk (HR=5.19, 95% CI=3.93-6.86, p < 0.001) compared to those aged 0-29 years. Marital status also influenced survival, with married patients showing better survival rates than single patients (HR=0.67, 95% CI=0.57-0.78, p < 0.001). Histologic type and tumor size were critical factors, with non-keratinizing SCC having a better prognosis. Radiation therapy was associated with improved survival (HR=0.27, 95% CI=0.16-0.45, p < 0.001), while the absence of chemotherapy increased mortality risk (HR=1.66, 95% CI=1.37-2.01, p < 0.001). Conclusions:The findings highlight the significant impact of metastasis status, age, marital status, histologic type, tumor size, and treatment modalities on survival outcomes in NPC patients. These factors should be considered when devising personalized treatment plans to improve survival rates.