title: Staging computed tomography of the thorax for nasopharyngeal carcinoma.
abstract: BACKGROUND
  To assess the role of staging CT of the thorax in advanced nodal stage nasopharyngeal carcinoma and to examine the hypothesis that contiguous spread of nodal metastases from the supraclavicular region to the upper mediastinal region occurs in this cancer.
  
  
  METHODS
  Forty-four patients with newly diagnosed nasopharyngeal carcinoma with neck node metastases to the supraclavicular region (ie, AJCC N3b stage) underwent contrast-enhanced CT (CECT) thorax for staging. CT findings and clinical outcome were analyzed.
  
  
  RESULTS
  No patient was found to have intrathoracic metastasis, although 1 had hepatic metastases on CECT of the thorax, resulting in upstaging in 1 of 44 (2%) of patients. With a median follow-up time of 21 months, 3 patients had lung metastases and 2 had axillary nodal metastases develop without evidence of upper mediastinal nodal metastases.
  
  
  CONCLUSIONS
  Staging CECT of the thorax has a very low yield in nasopharyngeal carcinoma, even in advanced nodal disease. The hypothesis that contiguous spread of nodal metastases from the supraclavicular region to the upper mediastinum is not substantiated, and no evidence suggests that radiation therapy for N3b-stage disease needs to encompass the upper mediastinum.
authors.affiliation: Department of Clinical Oncology, Prince of Wales Hospital, Shatin, Hong Kong, China.
authors.forename: S
authors.initials: S
authors.lastname: Leung
authors.forename: H
authors.initials: H
authors.lastname: Cheung
authors.forename: P
authors.initials: P
authors.lastname: Teo
authors.forename: W W
authors.initials: WW
authors.lastname: Lam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000000981:diagnostic imaging; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000556:secondary*; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000145:classification / Q000000981:diagnostic imaging / Q000556:secondary; D008175:Lung Neoplasms / Q000145:classification / Q000000981:diagnostic imaging / Q000556:secondary; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000145:classification / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity; D013899:Thoracic Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000556:secondary*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media