title: Prognostic impact of magnetic resonance imaging-detected cranial nerve involvement in nasopharyngeal carcinoma.
abstract: BACKGROUND
  : The purpose of this study was to evaluate the prognostic value of magnetic resonance imaging (MRI)-detected cranial nerve (CN) involvement in nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  : Retrospective analysis was made of the magnetic resonance images and medical records of 924 consecutive patients with newly diagnosed NPC.
  
  
  RESULTS
  : Of 924 patients, 82 (8.9%) initially presented with CN palsy. CN involvement was seen on MRI in 333 (36%) patients. In T3-4 disease, MRI-evidenced CN involvement was associated with poor 3-year overall survival (OS) (35.7% vs 89.2%, P = .001) and distant metastasis-free survival (DMFS) (77.1% vs 87.8%, P = .002) rates. The survival curves of OS and DMFS for T3 disease with MRI-detected CN involvement approximated those of T4 disease (P = .322 and P = .809, respectively). In patients with MRI-detected CN involvement, no significant differences were observed in 3-year OS (78.3% vs 72.9%, P = .120), local relapse-free survival (LRFS) (89.7% vs 84.1%, P = .154), or DMFS (79.6% vs 74.8%, P = .466) rates between those with and without intracranial or orbital CN involvement. Furthermore, in patients with clinical and/or MRI-detected CN involvement, there were no significant differences in the 3-year OS (74.2% vs 80.1%, P = .067), LRFS (86.7% vs 87.9%, P = .899), or DMFS (74.6% vs 84.6%, P = .094) rates between symptomatic and asymptomatic patients.
  
  
  CONCLUSIONS
  : The incidence of MRI-detected CN involvement was higher than CN palsy. MRI-detected CN involvement has a negative impact on the prognosis independent of lesion localization and symptoms. Cancer 2009. (c) 2009 American Cancer Society.
authors.affiliation: State Key Laboratory of Oncology in Southern China, Guangzhou, People's Republic of China. li2@mail.sysu.edu.cn
authors.forename: Lizhi
authors.initials: L
authors.lastname: Liu
authors.forename: Shaobo
authors.initials: S
authors.lastname: Liang
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Yanping
authors.initials: Y
authors.lastname: Mao
authors.forename: Linglong
authors.initials: L
authors.lastname: Tang
authors.forename: Li
authors.initials: L
authors.lastname: Tian
authors.forename: Xinbiao
authors.initials: X
authors.lastname: Liao
authors.forename: Chunyan
authors.initials: C
authors.lastname: Cui
authors.forename: Aihua
authors.initials: A
authors.lastname: Lin
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003389:Cranial Nerve Diseases / Q000209:etiology; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000556:secondary*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology*; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D011379:Prognosis; D016019:Survival Analysis