Nodal grouping in nasopharyngeal carcinoma: prognostic significance, N classification, and a marker for the identification of candidates for induction chemotherapy

Liu, Yifei; Chen, Shenghuan; Dong, Annan; Ai, Fei; Quan, Tingting; Cui, Chunyan; Zhou, Jian; Liang, Shuli; Wang, Jiamin; Wang, Shunxin; Lu, Hua; Xu, Sheng‐Lan; Chen, Ming‐Yuan; Sun, Ying; Li, Haojiang; Liu, Lizhi

doi:10.1007/s00330-019-06537-6

Cited by 33 publications

(27 citation statements)

References 32 publications

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“…In a retrospective analysis of 1226 patients, Liu et al also show that rENE(+) was an independent prognostic factor for OS, but not for the PFS and DMFS. Similar to those study, we found that ENE was an negative independent factor for DMFS and OS 13 . The 10-year DMFS and DSS for patients with ENE(+) were signi cantly poorer than those with ENE(-) ( 79.8% vs 86.7%, and 71.7% vs 89.1%, p<0.01).…”

Section: Discussionsupporting

confidence: 91%

“…The distant metastasis rate in the CNN group was up to 18.7%, signi cant higher than those without CNN with 4.6%(P<0.01). In a study reported by Liu et al, CNN on MRI was also demonstrated as a signi cant negative prognostic factor for OS, LRRFS and DMFS, patients with CNN had signi cantly inferior 5-year OS (82.6% vs. 87.8%), LRRFS (86% vs. 92.1%) and DMFS (81.6% vs. 89.5%) than those without CNN 13 . Similar to those result, the present study also indicated the nodal necrosis was also associated with poor survival the patients with CNN had more inferior 10-year DSS(70.8% vs 88.6%) and DMFS(80.8% vs 91.9%) than those without CNN.…”

Section: Discussionmentioning

confidence: 85%

“…As the evidence showed the imaging technique of CT/MR exhibit the similar accuracy in the diagnosis of ENE compared with the pathological method 22 . Several studies related to NPC has demonstrated that patients with ENE were associated with high risk of metastasis and poor outcome [10][11][12][13] . In the report related to 1616 patients with NPC, the patients with rENE(+) had a signi cantly inferior 5-years DMFS (73.8% vs 88.4%,p < 0.01) and OS (77.3% vs 87.6%, p < 0.01) when compared to patients with rENE(-), and proposed to re ne the Nclassi cation according to the rENE 12 .…”

Section: Discussionmentioning

confidence: 99%

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The Value of Cervical Node Features in Predicting Long-Term Survival of Nasopharyngeal Carcinoma in Intensity-Modulated Radiotherapy Era

Tian

Zeng

Huang³

et al. 2020

Preprint

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The prognostic value of cervical node features in nasopharyngeal carcinoma(NPC) patients treated with intensity-modulated radiotherapy (IMRT) was controversial. In this study, about 1752 patients after IMRT from 2008 to 2011 were recruited. The nodal features including the nodal number, maximize dimension diameter, extranodal extension(ENE)and cervical node necrosis(CNN) were retrospective analyzed. Univariate Cox and multivariate proportional hazard regression models were used to test the prognostic value of nodal features. Prognostic nomograms were built to predict the survival. The 10-year distant metastases free survival (DMFS) and disease-specific survival(DSS) rates were 86.5% and 80.8%. By multivariate analysis, the independent factors for the DSS were gender, age, lactate dehydrogenase (LDH), CNN, ENE, T stage and N stage. Nomogram A (without nodal features ) and nomogram B (with nodal features) were built. The calibration curve for the probability of DSS showed good agreement between prediction by nomogram and actual observation.The C-index of nomogram B was higher than for nomogram A in predicting DSS ( 0.708 vs 0.676,P <.01). These results demonstrated the nodal features including the ENE and CNN were negative prognostic factors in patients with NPC, and the prognostic nomogram incorporating the nodal features was more accurate.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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The Value of Cervical Node Features in Predicting Long-Term Survival of Nasopharyngeal Carcinoma in Intensity-Modulated Radiotherapy Era

Tian

Zeng

Huang³

et al. 2020

Preprint

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“…This is reasonable since the models were originally trained to be prognostic for OS. Not only this, but DMFS is considered more relevant to patient N stage, which is determined based on metastatic lymph nodes [ 27 ]. However, both the features selected for the prognostic signature for OS (the primary endpoint) came from the primary tumor and therefore capture the spatial heterogeneity of the main tumor alone.…”

Section: Discussionmentioning

confidence: 99%

Baseline MRI-Radiomics Can Predict Overall Survival in Non-Endemic EBV-Related Nasopharyngeal Carcinoma Patients

Bologna

Corino

Calareso

et al. 2020

Cancers

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Advanced stage nasopharyngeal cancer (NPC) shows highly variable treatment outcomes, suggesting the need for independent prognostic factors. This study aims at developing a magnetic resonance imaging (MRI)-based radiomic signature as a prognostic marker for different clinical endpoints in NPC patients from non-endemic areas. A total 136 patients with advanced NPC and available MRI imaging (T1-weighted and T2-weighted) were selected. For each patient, 2144 radiomic features were extracted from the main tumor and largest lymph node. A multivariate Cox regression model was trained on a subset of features to obtain a radiomic signature for overall survival (OS), which was also applied for the prognosis of other clinical endpoints. Validation was performed using 10-fold cross-validation. The added prognostic value of the radiomic features to clinical features and volume was also evaluated. The radiomics-based signature had good prognostic power for OS and loco-regional recurrence-free survival (LRFS), with C-index of 0.68 and 0.72, respectively. In all the cases, the addition of radiomics to clinical features improved the prognostic performance. Radiomic features can provide independent prognostic information in NPC patients from non-endemic areas.

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“…Admittedly, there is still an incidence of around 20% of treatment failures, including locoregional and distant recurrence, in LANPC with stage N1 disease [19]. Thus, identifying high-risk patients and finding individualized treatment strategy are urgent.…”

Section: Discussionmentioning

confidence: 99%

Can neoadjuvant chemotherapy improve survival in stage T3-4N1 nasopharyngeal carcinoma? A propensity matched analysis

et al. 2020

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Background: To estimate the efficacy of neoadjuvant chemotherapy (NCT) in stage T3-4N1 nasopharyngeal carcinoma (NPC). Methods: Data on stage T3-4N1 NPC patients treated with concurrent chemoradiotherapy (CCRT) with or without NCT at the Sun Yat-sen University Cancer Center between January 2006 and December 2013 were retrospectively reviewed. Propensity score matching (PSM) was carried out to balance prognostic factors in NCT followed by CCRT (NCT + CCRT) group and CCRT group in a 1:1 ratio. Survival outcomes of matched patients in the two groups were compared, and prognostic factors were identified using Cox regression model. Results: A total of 282 patients were involved in this study, with 136 of NCT + CCRT group and 146 of CCRT group. After PSM, 85 pairs of patients were selected. There were no significant differences in 5-year overall survival (OS), locoregional recurrence-free survival (LRFS), distant recurrence-free survival (DRFS), and recurrence-free survival (RFS) between NCT + CCRT group and CCRT group (81.0% vs. 77.5%, P = 0.750; 85.8% vs. 88.1%, P = 0.495; 92.5% vs. 93.9%, P = 0.759; 81.0% vs.77.5%, P = 0.919, respectively). Multivariate analysis found that smoking history (P = 0.044) and T classification (P = 0.027) were independent prognostic factors for OS, lymph node diameter (P = 0.032) was independent prognostic factor for LRFS, positive pretreatment lymph node condition (PLNC), which was defined as the lymph node necrosis or confluent, was independent prognostic factor for DRFS (P = 0.007), and RFS (P = 0.009). Lower 5-year OS (82.7% vs. 94.1%, P = 0.014), DRFS (79.3% vs. 96.2%, P = 0.003), and RFS (62.4% vs. 86.8%, P = 0.001) were found in positive PLNC group compared with negative PLNC group. In terms of toxicities, the incidences of acute hematological Grade 3-4 adverse events (AEs) were higher in NCT + CCRT group compared with CCRT group (P < 0.05), while no significant difference was observed in the rates of non-hematological Grade 3-4 AEs between these two groups (P > 0.05).

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Nodal grouping in nasopharyngeal carcinoma: prognostic significance, N classification, and a marker for the identification of candidates for induction chemotherapy

Cited by 33 publications

References 32 publications

The Value of Cervical Node Features in Predicting Long-Term Survival of Nasopharyngeal Carcinoma in Intensity-Modulated Radiotherapy Era

The Value of Cervical Node Features in Predicting Long-Term Survival of Nasopharyngeal Carcinoma in Intensity-Modulated Radiotherapy Era

Baseline MRI-Radiomics Can Predict Overall Survival in Non-Endemic EBV-Related Nasopharyngeal Carcinoma Patients

Can neoadjuvant chemotherapy improve survival in stage T3-4N1 nasopharyngeal carcinoma? A propensity matched analysis

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