Retropharyngeal lymph node metastasis in nasopharyngeal carcinoma detected by magnetic resonance imaging
Open Access
- 8 July 2008
- Vol. 113 (2), 347-354
- https://doi.org/10.1002/cncr.23555
Abstract
BACKGROUND. Retropharyngeal lymph node (RLN) metastasis was not included in the current American Joint Committee on Cancer (AJCC) staging system (6th edition) for nasopharyngeal carcinoma (NPC).The object of the current study was to investigate the prognostic value and staging categories of RLN metastasis in NPC detected by magnetic resonance imaging (MRI). METHODS. All 924 consecutive patients with newly diagnosed NPC were examined with MRI before treatment with definitive intent radiotherapy. RESULTS. The incidence of RLN metastasis was 73.5%. On multivariate analysis, RLN metastasis was found to be an independent prognostic factor for distant metastasis-free survival (DMFS) in all patients (P = .040). In patients with N0 disease, significant differences were observed between patients with and those without RLN metastasis after adjusting for T classification (P = .046). With regard to laterality, no significant differences were observed in DMFS between patients with unilateral and bilateral RLN metastasis in N0 disease (P = .734). No significant difference in the hazards ratios for either DMFS or disease-free survival (DFS) was found between patients with N0 disease with RLN metastasis and patients with N1 disease (P = .092 and P = .149, respectively). When RLN was classified as N1 disease, there was a better segregation of different N classifications in terms of DFS and DMFS curves, whereas the difference in hazards ratios for N0 and N1 disease was more obvious in DMFS (from 0.461 vs 0.785 to 0.317 vs 0.690). CONCLUSIONS. The results of the current MRI-based study demonstrate that RLN metastasis affects the DMFS rates of NPC. The authors propose that RLN metastasis be classified as N1 disease, regardless of its laterality. Cancer 2008. ©2008 American Cancer Society.Keywords
This publication has 21 references indexed in Scilit:
- Retropharyngeal Lymph Node Metastasis in Nasopharyngeal Carcinoma: Prognostic Value and Staging CategoriesClinical Cancer Research, 2007
- Presalvage prostate‐specific antigen (PSA) and PSA doubling time as predictors of biochemical failure of salvage cryotherapy in patients with locally recurrent prostate cancer after radiotherapyCancer, 2006
- Chemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patientsInternational Journal of Radiation Oncology*Biology*Physics, 2006
- Treatment results for nasopharyngeal carcinoma in the modern era: The Hong Kong experienceInternational Journal of Radiation Oncology*Biology*Physics, 2005
- Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy: The Hong Kong experienceInternational Journal of Radiation Oncology*Biology*Physics, 2004
- Staging of Nasopharyngeal Carcinoma: Suggestions for Improving the Current UICC/AJCC Staging SystemClinical Oncology, 2004
- Is the 1997 AJCC staging system for nasopharyngeal carcinoma prognostically useful for Chinese patient populations?International Journal of Radiation Oncology*Biology*Physics, 2001
- Paranasopharyngeal Space Involvement in Nasopharyngeal Cancer: Dectection by CT and MRIClinical Oncology, 2000
- Nasopharyngeal carcinoma: Orderly neck node spreadInternational Journal of Radiation Oncology*Biology*Physics, 1990
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958