ABSTRACT
BACKGROUND: The purpose of this study was to determine the prevalence of cystic lymph nodal metastasis (CLNM) and its prognostic value in patients with nasopharyngeal carcinoma (NPC). METHODS: A retrospective review was conducted on 257 patients with NPC, analyzing the presence of CLNM on MRI or CT scans. Oncologic outcomes were performed using the Kaplan-Meier analysis. RESULTS: One hundred eleven patients (43.2%) had CLNM at diagnosis. Overall, patients with CLNM had a poorer disease-specific survival (DSS; P < .001) and overall survival (OS; P < .001) compared with patients without CLNM. When analyzed according to nodal status, CLNM was associated with a higher rate of distant metastasis recurrence (P = .007), a poorer DSS (P < .001), and a poorer OS (P < .001) among patients with N2 disease. CONCLUSION: The prevalence of CLNM was 43.2%. In patients with N2 disease, the presence of CLNM was significantly associated with a poorer DSS, OS, and increased risk of distant metastasis recurrence.
Subject(s)
Carcinoma/mortality , Carcinoma/pathology , Cause of Death , Lymph Nodes/pathology , Magnetic Resonance Imaging/methods , Nasopharyngeal Neoplasms/mortality , Nasopharyngeal Neoplasms/pathology , Adult , Aged , Analysis of Variance , Carcinoma/diagnostic imaging , China , Cohort Studies , Disease-Free Survival , Female , Humans , Kaplan-Meier Estimate , Lymphatic Metastasis , Male , Middle Aged , Multivariate Analysis , Nasopharyngeal Carcinoma , Nasopharyngeal Neoplasms/diagnostic imaging , Neoplasm Invasiveness/pathology , Neoplasm Staging , Retrospective Studies , Risk Assessment , Survival Analysis , Tomography, X-Ray Computed/methodsABSTRACT
BACKGROUND: The purpose of this study was to determine the prognostic value of relapse status (recurrent vs residual disease) in patients receiving surgical salvage for nasopharyngeal carcinoma (NPC). METHODS: Retrospective review was conducted on 52 patients who underwent salvage surgery for locoregional relapse of NPC. Univariate and multivariate analyses were used to investigate the prognostic value of relapse status. RESULTS: Median follow-up duration was 44.4 months. Mean overall survival (OS) and disease-free survival (DFS) for patients with NPC with residual and recurrent disease after surgical salvage were 107.4 and 54.4 months, and 83.6 and 34.6 months, respectively (p < .001). This improved survival was demonstrated regardless whether the relapse was at the primary or nodal site. Multivariate analysis revealed that recurrent disease status and nodal disease relapse were independent poor prognostic factors for survival in patients receiving salvage surgery for NPC. CONCLUSION: In patients undergoing surgical salvage for NPC relapse, residual disease carries a better prognosis than recurrent disease. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1393-1400, 2016.