title: Prognostic value of retropharyngeal node involvement in CT-based lymph node-positive pharyngeal cancer following radiotherapy.
abstract: BACKGROUND
  The objective of this study was to evaluate the impact of metastasis to the retropharyngeal nodes (RPN) in CT-based lymph node-positive head and neck patients by comparing other node levels.
  
  
  METHODS
  A total of 175 CT-based lymph node-positive patients with carcinoma of the head and neck were managed with definitive radiation therapy. RPN involvement was identified only in pharyngeal cancer. One hundred and twenty-seven patients were investigated using CT and MRI following the guidelines on CT-based elective nodal delineation. Fifty-two patients received induction chemotherapy and 58 received concurrent chemoradiotherapy.
  
  
  RESULTS
  RPN involvement and lymph node size were identified as having a significant effect on the disease-free survival (DFS) in univariate analysis. Concurrent chemotherapy and RPN involvement significantly affected DFS on multivariate analysis in all pharyngeal cancer patients and non-nasopharyngeal cancer (NNP) patients. RPN involvement, level IV involvement and concurrent chemotherapy also significantly affected locoregional control.
  
  
  CONCLUSIONS
  Our study confirmed a poor outcome was associated with RPN involvement in patients with CT-based node-positive pharyngeal cancer and NNP patients definitively treated by radiotherapy.
authors.affiliation: Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Japan. ogino1ro@urahp.yokohama-cu.ac.jp
authors.forename: Ichiro
authors.initials: I
authors.lastname: Ogino
authors.forename: Mamoru
authors.initials: M
authors.lastname: Tsukuda
authors.forename: Tomio
authors.initials: T
authors.lastname: Inoue
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Mikami
authors.forename: Tomoko
authors.initials: T
authors.lastname: Itazawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Matsuda
authors.forename: Izumi
authors.initials: I
authors.lastname: Koike
authors.forename: Choichi
authors.initials: C
authors.lastname: Horiuchi
authors.forename: Motoko
authors.initials: M
authors.lastname: Omura
authors.forename: Takahide
authors.initials: T
authors.lastname: Taguchi
mesh_terms: D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis; D014057:Tomography, X-Ray Computed