Retropharyngeal Lymph Node Metastasis in Nasopharyngeal Carcinoma: Prognostic Value and Staging Categories

Abstract

Purpose: To investigate the incidence, prognostic value, and staging categories of retropharyngeal lymph node (RLN) metastasis in nasopharyngeal carcinoma (NPC). Experimental Design: We did a retrospective review of the data from 749 biopsy-proved nonmetastatic NPC patients. All patients had undergone contrast-enhanced computed tomography and had radiotherapy as their primary treatment. Results:The incidence of RLN metastasis was 51.5%. After adjusting for tumor (T) and node (N) classifications, a borderline significant difference of distant metastasis-free survival (DMFS) rates was observed between patients with or without RLN metastasis. In N 0 disease, the presence of RLN metastasis was a significant independent predictor for overall survival (OS), loco-regional relapse-free survival, and DMFS in multivariate Cox modeling analysis. No significant difference was observed in all end points between patients with unilateral and bilateral RLN metastasis. The hazard ratios of death and distant failure for N 0 with RLN metastasis were similar to N 1 . The survival curve of OS and DMFS for N 0 disease with RLN metastasis had approximated that of N 1 disease. The survival curve of OS for T 1 disease with RLN metastasis was approximately the same as T 2 disease. However, the survival curve of DMFS for T 1 disease with RLN metastasis was approximately the same as inT 3 disease. Conclusions: RLN metastasis has a tendency to affect the DMFS rates of patients with NPC. Retropharyngeal node involvement has a negative effect on the prognosis of N 0 disease. RLN metastasis should be classified as N 1 .

Diffusion-weighted imaging to differentiate metastatic from non-metastatic retropharyngeal lymph nodes in nasopharyngeal carcinoma

“…14 The correct diagnosis of RLNs is, thus, important in order to understand the course of the disease in response to therapy. Because of their anatomical location, RLNs are not amenable to evaluation using manual palpation or histological analysis, Figure 3 The receiver operating characteristic (ROC) curve of size-based and apparent diffusion coefficient (ADC)-based criteria.…”

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

“…All patients who had LN-positive (N2/N3) disease underwent emission CT, but only 56 patients (6.1%) underwent PET-CT. Medical records and imaging studies were analyzed retrospectively, and all patients were staged according to the American Joint Committee on Cancer (AJCC) staging system, sixth edition. 13 When retropharyngeal LN (RLN) metastasis is classified as N1, 14 …”

“…Details regarding the radiotherapy techniques carried out at the Cancer Center of Sun Yat-sen University have been reported previously. 14,18,19 Most patients (517 of 629; 82.2%) with stage III or stage IV disease (classified as T3-T4 or N2-N3) received neoadjuvant, concomitant, or adjuvant chemotherapy in conjunction with a platinum-based therapeutic clinical trial. When possible, salvage treatments (including afterloading, surgery, and chemotherapy) were provided in the event of a documented relapse or when the disease persisted despite therapy.…”

Ekspresi mRNA LMP2A Epstein-Barr Virus dari Biopsi Jaringan dalam Blok Parafin Berpotensi sebagai Biomarka dalam Diagnosis Karsinoma Nasofaring

“…Pendahuluan KNF mempunyai sifat berbeda dibandingkan dengan keganasan pada kepala leher yang lain, karena sifatnya yang sangat invasif dan sangat mudah bermetastasis (Liu et al, 2003;Jiang et al, 2004;Ma et al, 2007;Tang et al, 2008). Salah satu penyebab KNF adalah infeksi oleh Epstein-Barr Virus (EBV) (Gu et al, 2012;Shen et al, 2015).…”