title: The volume of retropharyngeal nodes predicts distant metastasis in patients with advanced nasopharyngeal carcinoma.
abstract: We investigated the effect of retropharyngeal nodal volumes (RNV) on distant metastasis in patients with advanced nasopharyngeal carcinoma (NPC). From February 2000 to June 2006, a total of 181 patients with biopsy-proven NPC, no distant metastasis, and available pre-treatment magnetic resonance imaging (MRI) were retrospectively reviewed. Most of the patients (95.6%) had stage III/IV diseases. The contour of retropharyngeal nodes ≥5mm was delineated on the axial slides of pre-treatment T2-weighted MRI without contrast enhancement. The RNV was calculated by the Eclipse™ treatment planning software. The primary end-points were subsequent distant failure rates and distant metastasis failure-free survival (DMFFS). The pre-treatment RNV in patients who developed distant failure was higher than in those without distant failure (P=0.0536). The distant failure rates between the patients with RNV > and ≤4.68cm(3) were 33.3% and 16.0%, respectively (P=0.0112). The rates of 7-year DMFFS in patients with RNV > and ≤4.68cm(3) were 66.4% and 83.5%, respectively (P=0.0043). Multivariate Cox analysis showed N-stage (P<0.001), gender (P=0.026), and RNV (P=0.088) were important predictors for DMFFS. We conclude that the RNV measured by MRI is a potential predictor of distant metastasis in patients with advanced NPC.
authors.affiliation: Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Kuan-Wen
authors.initials: KW
authors.lastname: Chen
authors.forename: Wen-Yi
authors.initials: WY
authors.lastname: Wang
authors.forename: Wen-Miin
authors.initials: WM
authors.lastname: Liang
authors.forename: Chih-Wen
authors.initials: CW
authors.lastname: Twu
authors.forename: Jeffrey Y C
authors.initials: JY
authors.lastname: Chao
authors.forename: Kai-Li
authors.initials: KL
authors.lastname: Liang
authors.forename: Ching-Te
authors.initials: CT
authors.lastname: Wu
authors.forename: Rong-San
authors.initials: RS
authors.lastname: Jiang
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Shih
authors.forename: Jin-Ching
authors.initials: JC
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology* / Q000556:secondary; D009367:Neoplasm Staging; D010614:Pharynx; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult