N-staging by magnetic resonance imaging for patients with nasopharyngeal carcinoma: Pattern of nodal involvement by radiological levels

Ng, Wai Tong; Lee, Anne W.M.; Kan, WK; Chan, J K W; Pang, Elizabeth; Yau, Tsz Kok; Lau, K Y

doi:10.1016/j.radonc.2006.11.010

Cited by 85 publications

(80 citation statements)

References 27 publications

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“…It is believed that, because of a rich lymphatic network in the nasopharynx, the incidence rate of cervical lymphatic metastasis in NPC patients is substantially high. The clinically evident cervical lymphadenopathy was reported to occur in more than 85 % of the patients with NPC (Ng et al, 2007;Tang et al, 2009), which was near the rate of approximately 86% in a total of 4,342 NPC patients admitted in our hospital from May 1989 to Oct. 2009. However, some patients with extensive primary tumors in the nasopharynx did not present detectable neck lymph adenopathy, representing a specific clinical pattern.…”

Section: Introductionmentioning

confidence: 64%

Long Term Outcomes and Prognostic Factors of N₀Stage Nasopharyngeal Carcinoma: a Single Institutional Experience with 610 Patients

Sun

Chen²,

Chen³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Treatment responses of N 0 stage nasopharyngeal carcinoma were firstly analyzed comprehensively to evaluate long term outcomes of patients and identify prognostic factors. A total of 610 patients with N 0 NPC, undergoing definitive radiotherapy to their primary lesion and prophylactic radiation to upper neck, were reviewed retrospectively. Concomitant chemotherapy was administrated to 65 out of the 610. Survival rates of the patients were calculated using the Kaplan-Meier method and compared by log-rank test. Prognostic factors were identified by the Cox regression model. The study revealed the 5-year and 10-year overall, disease-free, disease-specific, local failure-free, regional failure-free, locoregional failure-free and distant metastasis-free survival rates to be 78.7% and 66.8%, 68.8% and 55.8%, 79.9% and 70.4%, 81.2% and 72.5%, 95.8% and 91.8%, 78.3% and 68.5%, 88.5% and 85.5%, respectively. There were 192 patients experiencing failure (31.5%) after radiotherapy or chemoradiotherapy. Of these, local recurrence, regional relapse and distant metastases as the first event of failure occurred in 100 (100/610, 16.4%), 15(15/610, 2.5%) and 52 (52/610, 8.5%), respectively. Multivariate analysis showed that T stage was the only independent prognostic factor for patients with N 0 NPC (P=0.000). Late T stage (P=0.000), male (P=0.039) and anemia (P=0.007) were independently unfavorable factors predicting disease-free survival. After treatment, satisfactory outcome wasgenerally achieved in patients with N 0 NPC. Local recurrence represented the predominant mode of treatment failure, while T stage was the only independent prognostic factor for overall survival. Late T stage, male gender, and anemia independently predicted lower possibility of the disease-free survival.

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Section: Introductionmentioning

confidence: 64%

Long Term Outcomes and Prognostic Factors of N₀Stage Nasopharyngeal Carcinoma: a Single Institutional Experience with 610 Patients

Sun

Chen²,

Chen³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…Ng et al 21 defined SCF radiologically and replaced clinical SCF involvement with lower level involvement that includes Levels IV and Vb, which still is predictive for both distant control and overall survival. In the RTOG consensus, the SCF is not 1 of the neck levels specified in the LN-negative neck.…”

Section: Discussionmentioning

confidence: 99%

The volume to be irradiated during selective neck irradiation in nasopharyngeal carcinoma

Tang

Mao

Liu

et al. 2009

Cancer

115

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Background: Apathy, defined as decreased goal‐directed activity, has been observed in Parkinson's disease. A number of cognitive/psychiatric features have been documented in essential tremor, yet we are unaware of studies of apathy. Methods: Using the Apathy Evaluation Scale (range = 18–72 [more apathy]), we compared 79 essential tremor cases, 20 dystonia cases, and 39 Parkinson's disease cases with 80 normal controls. Results: The score of the Apathy Evaluation Scale was higher in essential tremor, dystonia, and Parkinson's disease cases than controls (all P ≤ .04). Parkinson's disease cases had the highest scores. Analyses stratified by presence/absence of depressive symptoms indicated the presence of a group of apathetic but nondepressed cases. Conclusions: Patients with Parkinson's disease, essential tremor, and dystonia had elevated apathy scores. Features of apathy seemed to occur in these conditions independent of depressive symptoms. The mechanistic basis for the apparent increased features of apathy in essential tremor and dystonia deserves further study. © 2011 Movement Disorder Society

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“…The assignment of lymph node location was determined according to RTOG guidelines (8,14). The following 11 nodal groups were assessed: RP, level Ia, level Ib, level IIa, level IIb, level III, level IV, level V, level VI, SCF, and retrostyloid.…”

Section: Methodsmentioning

confidence: 99%

“…However, N staging by the 6th edition of the AJCC system for NPC does have limitations. First, the N staging criteria mainly depend on clinical examination, which is by no means perfect (8). For example, palpation-determined nodal size differs among clinicians.…”

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confidence: 99%

The N Staging System in Nasopharyngeal Carcinoma with Radiation Therapy Oncology Group Guidelines for Lymph Node Levels Based on Magnetic Resonance Imaging

Mao¹,

Liang²,

Liu³

et al. 2008

Clinical Cancer Research

135

130

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Purpose:To evaluate the prognostic value of variables including nodal size, level, laterality, extranodal neoplastic spread (ENS), and necrosis in patients with nasopharyngeal carcinoma (NPC) and further explore the feasibility of an N-staging system using Radiation Therapy Oncology Group (RTOG) guidelines for lymph node levels based on magnetic resonance imaging (MRI). Experimental Design: The MRI scans of 924 patients with histologically diagnosed nondisseminated NPC were reviewed retrospectively. The distribution of the tumors was mapped using RTOG guidelines and laterality. The multiplicity of each tumor was calculated, as well as the size and status of ENS and the necrosis of individual nodes. Results: Nodal level, cervical lymph node laterality, and ENS were independent prognostic factors for disease failure and distant failure in multivariate analyses. There was no significant difference in the hazard ratios (HR) for distant failure between level II and retropharyngeal, level Ib, levelV, or level III involvement, whereas patients with level IVand supraclavicular fossa involvement had a significant increase in HRs. The subsets that made up a given N stage group had similar HRs for distant failure. Both the HRs for disease failure and distant failure by the proposed N staging system between one stage and the next were statistically significant (P < 0.05). The survival curves of disease-free survival and distant metastasis-free survival for all subclassifications of N stage showed significant difference from the adjacent stage (P < 0.05). The overall distribution pattern of the proposed N staging was more equitable than that of the 6th American Joint Committee on Cancer N staging. Conclusions: Nodal variables including level, cervical lymph node laterality, and ENS are independent prognostic factors for NPC. The proposed N staging system of NPC using RTOG guidelines based on MRI is highly predictive and may provide a more objective method for staging NPCs.

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N-staging by magnetic resonance imaging for patients with nasopharyngeal carcinoma: Pattern of nodal involvement by radiological levels

Cited by 85 publications

References 27 publications

Long Term Outcomes and Prognostic Factors of N₀Stage Nasopharyngeal Carcinoma: a Single Institutional Experience with 610 Patients

Long Term Outcomes and Prognostic Factors of N₀Stage Nasopharyngeal Carcinoma: a Single Institutional Experience with 610 Patients

The volume to be irradiated during selective neck irradiation in nasopharyngeal carcinoma

The N Staging System in Nasopharyngeal Carcinoma with Radiation Therapy Oncology Group Guidelines for Lymph Node Levels Based on Magnetic Resonance Imaging

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N-staging by magnetic resonance imaging for patients with nasopharyngeal carcinoma: Pattern of nodal involvement by radiological levels

Cited by 85 publications

References 27 publications

Long Term Outcomes and Prognostic Factors of N0Stage Nasopharyngeal Carcinoma: a Single Institutional Experience with 610 Patients

Long Term Outcomes and Prognostic Factors of N0Stage Nasopharyngeal Carcinoma: a Single Institutional Experience with 610 Patients

The volume to be irradiated during selective neck irradiation in nasopharyngeal carcinoma

The N Staging System in Nasopharyngeal Carcinoma with Radiation Therapy Oncology Group Guidelines for Lymph Node Levels Based on Magnetic Resonance Imaging

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Product

Resources

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Long Term Outcomes and Prognostic Factors of N₀Stage Nasopharyngeal Carcinoma: a Single Institutional Experience with 610 Patients

Long Term Outcomes and Prognostic Factors of N₀Stage Nasopharyngeal Carcinoma: a Single Institutional Experience with 610 Patients