Prognostic Value and Staging Classification of Lymph Nodal Necrosis in Nasopharyngeal Carcinoma after Intensity-Modulated Radiotherapy
| Autor: | Xiaozhong Chen, Yanru Feng, Qiaoying Hu, Caineng Cao |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 0301 basic medicine Cancer Research medicine.medical_specialty Multivariate analysis Adolescent Intensity-modulated radiotherapy medicine.medical_treatment Necrosis Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans Stage (cooking) Aged Aged 80 and over Nasopharyngeal Carcinoma medicine.diagnostic_test business.industry Hazard ratio Cancer Nasopharyngeal Neoplasms Magnetic resonance imaging Middle Aged Prognosis medicine.disease Magnetic Resonance Imaging Confidence interval Radiation therapy 030104 developmental biology Oncology Nasopharyngeal carcinoma 030220 oncology & carcinogenesis Neoplasm staging Feasibility Studies Original Article Female Lymph Nodes Radiotherapy Intensity-Modulated Radiology business |
| Zdroj: | Cancer Research and Treatment : Official Journal of Korean Cancer Association |
| ISSN: | 2005-9256 1598-2998 |
| DOI: | 10.4143/crt.2018.595 |
| Popis: | Purpose The aim of the present study was to evaluate the prognostic value of magnetic resonance imaging (MRI)‒determined lymph nodal necrosis (LNN) in nasopharyngeal carcinoma (NPC) and explore the feasibility of an N-classification system based on the 8th edition of the American Joint Committee on Cancer (AJCC) system. Materials and methods The MRI scans of 616 patients with newly diagnosed stage T1-4N1-3M0 NPC who were treated with definitive intensity-modulated radiotherapy (IMRT) were reviewed. Results Multivariate analysis showed that LNN was an independent negative prognostic predictor of distant metastasis free survival (hazard ratio, 1.634; 95% confidence interval, 1.023 to 2.609; p=0.040) and overall survival (hazard ratio, 2.154; 95% confidence interval, 1.282 to 3.620; p=0.004). Patients of classification N1 disease with LNN were reclassified as classification N2, and classification N2 disease with LNN as classification N3 in the proposed N-classification system. Correlation with death and distant failure was significant, and the total difference between N1 and N3 was wider with the proposed system. Conclusion MRI-determined LNN is an independent negative prognostic factor for NPC. The proposed N classification system is powerfully predictive. |
| Databáze: | OpenAIRE |
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