title: Retropharyngeal nodal metastasis related to higher rate of distant metastasis in patients with N0 and N1 nasopharyngeal cancer.
abstract: BACKGROUND
  Retropharyngeal lymph node (RLN) staging in nasopharyngeal carcinoma (NPC) can be controversial.
  
  
  METHODS
  We retrospectively reviewed all patients with T(2-4), N(0-1) NPC treated between 1992 and 1994 to examine if RLN metastasis resulted in an increased incidence of distant metastases.
  
  
  RESULTS
  Of the 667 patients with NPC, 395 had T(2-4), N(0-1) disease, 140 had N(0), and 255 had N(1). All had staging CT scans and were treated with radiotherapy. Median follow-up was 8.3 years. Seventy-four percent showed undifferentiated histology. In this cohort, 187 (47%) had RLN metastases. Multivariate analysis showed that RLN conferred a higher hazard for distant metastasis (p = .04). Using the Kaplan-Meier method, patients with N(0) disease and RLN had a similar hazard for distant metastases as patients with N(1) disease when compared with patients with N(0) disease and without RLN.
  
  
  CONCLUSIONS
  Patients with N(0) disease and RLN appear to share a similar prognosis to patients with N(1) disease.
authors.affiliation: Department of Radiation Oncology, National Cancer Centre, Singapore. ivantham@yahoo.com
authors.forename: Ivan Weng-Keong
authors.initials: IW
authors.lastname: Tham
authors.forename: Siew Wan
authors.initials: SW
authors.lastname: Hee
authors.forename: Swee Peng
authors.initials: SP
authors.lastname: Yap
authors.forename: Jeffrey Kit-Loong
authors.initials: JK
authors.lastname: Tuan
authors.forename: Joseph
authors.initials: J
authors.lastname: Wee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000532:radiotherapy / Q000556:secondary*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult