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Retropharyngeal nodal metastasis related to higher rate of distant metastasis in patients with N0 and N1 nasopharyngeal cancer

✍ Scribed by Ivan Weng-Keong Tham; Siew Wan Hee; Swee Peng Yap; Jeffrey Kit-Loong Tuan; Joseph Wee


Publisher
John Wiley and Sons
Year
2009
Tongue
English
Weight
143 KB
Volume
31
Category
Article
ISSN
1043-3074

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✦ Synopsis


Abstract

Background

Retropharyngeal lymph node (RLN) staging in nasopharyngeal carcinoma (NPC) can be controversial.

Methods

We retrospectively reviewed all patients with T~2–4~, N~0–1~ NPC treated between 1992 and 1994 to examine if RLN metastasis resulted in an increased incidence of distant metastases.

Results

Of the 667 patients with NPC, 395 had T~2–4~, N~0–1~ disease, 140 had N~0~, and 255 had N~1~. All had staging CT scans and were treated with radiotherapy. Median follow‐up was 8.3 years. Seventy‐four percent showed undifferentiated histology. In this cohort, 187 (47%) had RLN metastases. Multivariate analysis showed that RLN conferred a higher hazard for distant metastasis (p = .04). Using the Kaplan–Meier method, patients with N~0~ disease and RLN had a similar hazard for distant metastases as patients with N~1~ disease when compared with patients with N~0~ disease and without RLN.

Conclusion

Patients with N~0~ disease and RLN appear to share a similar prognosis to patients with N~1~ disease. © 2009 Wiley Periodicals, Inc. Head Neck, 2009