Prognostic value of retropharyngeal node involvement in CT-based lymph node-positive pharyngeal cancer following radiotherapy.
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.
Ogino
Ichiro
I
Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Japan. ogino1ro@urahp.yokohama-cu.ac.jp
Tsukuda
Mamoru
M
Inoue
Tomio
T
Mikami
Yasukazu
Y
Itazawa
Tomoko
T
Matsuda
Hideki
H
Koike
Izumi
I
Horiuchi
Choichi
C
Omura
Motoko
M
Taguchi
Takahide
T
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