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Prognostic value of parotid lymph node metastasis in patients with nasopharyngeal carcinoma receiving intensity-modulated radiotherapy.

Zhang Y, Li WF, Chen L, Mao YP, Guo R, Zhang F, Peng H, Liu LZ, Li L, Liu Q, Ma J - Sci Rep (2015)

Bottom Line: Ten of the 21 patients received irradiation of the involved PLNs; the PLN recurrence rate was significantly higher for patients who received no irradiation; thus only patients with irradiated PLN were included in prognostic analyses.PLN involvement had a significantly higher hazard ratio (HR) for distant failure than N2 disease and similar HR to N3 disease.In conclusion, PLN metastasis is rare in NPC and was associated with similarly poor DMFS as N3 disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.

ABSTRACT
The prognostic value and staging category of parotid lymph node (PLN) metastasis in nasopharyngeal carcinoma (NPC) remain unknown. We retrospectively reviewed MRI scans and medical records for 1811 NPC patients who received intensity-modulated radiotherapy. The diagnosis of PLN metastasis was mainly based on MRI follow-up. Twenty-five positive PLNs in 21/1811 patients were identified; the incidence of PLN metastasis was 1.2%. PLN metastasis was significantly associated with advanced N-category and stage. Ten of the 21 patients received irradiation of the involved PLNs; the PLN recurrence rate was significantly higher for patients who received no irradiation; thus only patients with irradiated PLN were included in prognostic analyses. PLN metastasis was associated with significantly poorer progression-free survival, overall survival and distant metastasis-free survival (DMFS), but not regional or local relapse-free survival, in univariate analysis. In multivariate analysis, PLN metastasis was also significantly associated with poor DMFS. PLN involvement had a significantly higher hazard ratio (HR) for distant failure than N2 disease and similar HR to N3 disease. In conclusion, PLN metastasis is rare in NPC and was associated with similarly poor DMFS as N3 disease. PLN metastasis should be suspected in advanced nodal disease, but diagnosed with care before administering aggressive treatment.

No MeSH data available.


Related in: MedlinePlus

(A) Progression-free survival, (B) overall survival, (C) distant metastasis-free survival and (D) regional relapse-free survival curves for patients with NPC stratified by N-category (as defined by the 7th UICC/AJCC system) and parotid lymph node (PLN) involvement. The 11 patients whose involved PLNs were not irradiated were excluded.
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f3: (A) Progression-free survival, (B) overall survival, (C) distant metastasis-free survival and (D) regional relapse-free survival curves for patients with NPC stratified by N-category (as defined by the 7th UICC/AJCC system) and parotid lymph node (PLN) involvement. The 11 patients whose involved PLNs were not irradiated were excluded.

Mentions: To evaluate the relative severity of PLN metastasis, the 1800 patients were classified into five groups according to lymph node involvement: N0 disease (n = 308), N1 disease (n = 1056), N2 disease (n = 271), N3 disease (n = 155), and PLN metastasis (n = 10). The PLN metastasis group had the poorest PFS, OS, DMFS and RRFS rates of the five groups (Fig. 3). Compared to patients with N2 disease (HR = 1), patients with PLN metastasis had a significantly higher HR for distant failure (HR, 3.13; 95% CI, 1.12–8.73; P = 0.03; Table 3) adjusted for sex, age, chemotherapy and T-category. However, no significant difference in the HRs for progression or death (P = 0.45), death (P = 0.51), distant failure (P = 0.17) or regional failure (P = 0.18) were found between patients with PLN metastasis and patients with N3 disease.


Prognostic value of parotid lymph node metastasis in patients with nasopharyngeal carcinoma receiving intensity-modulated radiotherapy.

Zhang Y, Li WF, Chen L, Mao YP, Guo R, Zhang F, Peng H, Liu LZ, Li L, Liu Q, Ma J - Sci Rep (2015)

(A) Progression-free survival, (B) overall survival, (C) distant metastasis-free survival and (D) regional relapse-free survival curves for patients with NPC stratified by N-category (as defined by the 7th UICC/AJCC system) and parotid lymph node (PLN) involvement. The 11 patients whose involved PLNs were not irradiated were excluded.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4561956&req=5

f3: (A) Progression-free survival, (B) overall survival, (C) distant metastasis-free survival and (D) regional relapse-free survival curves for patients with NPC stratified by N-category (as defined by the 7th UICC/AJCC system) and parotid lymph node (PLN) involvement. The 11 patients whose involved PLNs were not irradiated were excluded.
Mentions: To evaluate the relative severity of PLN metastasis, the 1800 patients were classified into five groups according to lymph node involvement: N0 disease (n = 308), N1 disease (n = 1056), N2 disease (n = 271), N3 disease (n = 155), and PLN metastasis (n = 10). The PLN metastasis group had the poorest PFS, OS, DMFS and RRFS rates of the five groups (Fig. 3). Compared to patients with N2 disease (HR = 1), patients with PLN metastasis had a significantly higher HR for distant failure (HR, 3.13; 95% CI, 1.12–8.73; P = 0.03; Table 3) adjusted for sex, age, chemotherapy and T-category. However, no significant difference in the HRs for progression or death (P = 0.45), death (P = 0.51), distant failure (P = 0.17) or regional failure (P = 0.18) were found between patients with PLN metastasis and patients with N3 disease.

Bottom Line: Ten of the 21 patients received irradiation of the involved PLNs; the PLN recurrence rate was significantly higher for patients who received no irradiation; thus only patients with irradiated PLN were included in prognostic analyses.PLN involvement had a significantly higher hazard ratio (HR) for distant failure than N2 disease and similar HR to N3 disease.In conclusion, PLN metastasis is rare in NPC and was associated with similarly poor DMFS as N3 disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.

ABSTRACT
The prognostic value and staging category of parotid lymph node (PLN) metastasis in nasopharyngeal carcinoma (NPC) remain unknown. We retrospectively reviewed MRI scans and medical records for 1811 NPC patients who received intensity-modulated radiotherapy. The diagnosis of PLN metastasis was mainly based on MRI follow-up. Twenty-five positive PLNs in 21/1811 patients were identified; the incidence of PLN metastasis was 1.2%. PLN metastasis was significantly associated with advanced N-category and stage. Ten of the 21 patients received irradiation of the involved PLNs; the PLN recurrence rate was significantly higher for patients who received no irradiation; thus only patients with irradiated PLN were included in prognostic analyses. PLN metastasis was associated with significantly poorer progression-free survival, overall survival and distant metastasis-free survival (DMFS), but not regional or local relapse-free survival, in univariate analysis. In multivariate analysis, PLN metastasis was also significantly associated with poor DMFS. PLN involvement had a significantly higher hazard ratio (HR) for distant failure than N2 disease and similar HR to N3 disease. In conclusion, PLN metastasis is rare in NPC and was associated with similarly poor DMFS as N3 disease. PLN metastasis should be suspected in advanced nodal disease, but diagnosed with care before administering aggressive treatment.

No MeSH data available.


Related in: MedlinePlus