title: Prognostic significance of residual or recurrent lymph nodes in the neck for patients with nasopharyngeal carcinoma after radiotherapy.
abstract: BACKGROUND
  Nasopharyngeal carcinoma is the most frequently diagnosed primary tumor originating from the nasopharynx, and the preferred treatment modality is radiotherapy.
  
  
  OBJECTIVE
  To identify nasopharyngeal carcinoma prognostic factors in patients with residual or recurrent cervical lymph node metastases after radiotherapy.
  
  
  METHODS
  The clinicopathologic characteristics and prognoses of 67 nasopharyngeal carcinoma patients with residual or recurrent cervical lymph node metastases who were diagnosed and treated were analyzed retrospectively. The Chi-squared test and Cox proportional hazard regression model were used to investigate associations between survival and clinicopathological features. Cumulative survival plots were obtained using the Kaplan-Meier method.
  
  
  RESULTS
  Data analysis using the Cox proportional hazard regression model revealed that the size of residual or recurrent lymph node metastases, level V lymph node involvement, number of involved levels, surgical procedure performed, and distant metastases were significantly associated with overall survival. Chi-squared analysis only determined a significant correlation between distant metastases and patient survival. Furthermore, the Kaplan-Meier analysis demonstrated that the 1-, 3-, and 5-year survival rates for patients were 86.6%, 52.2%, and 38.6%, respectively. Radical neck dissection resulted in substantially longer overall survival than modified neck dissection.
  
  
  CONCLUSIONS
  The size of residual or recurrent lymph node metastases, level V lymph node involvement, number of involved levels, surgical procedure performed, and presence of distant metastases were prognostic factors for nasopharyngeal carcinoma patients with residual or recurrent cervical lymph node metastases after radiotherapy, with distant metastases being the most important determinant. Classical radical neck dissection is recommended for treating recurrent nodal disease in nasopharyngeal carcinoma.
authors.affiliation: Department of Otorhinolaryngology, Fuzhou General Hospital of Nanjing Command Zone of PLA, Fuzhou 350025, China.
authors.forename: Maoxin
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Otorhinolaryngology, Fuzong Clinical College of Fujian Medical University, Fuzhou General Hospital of Nanjing Command Zone of PLA, Fuzhou 350025, China.
authors.forename: Yilong
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Otorhinolaryngology, Fuzong Clinical College of Fujian Medical University, Fuzhou General Hospital of Nanjing Command Zone of PLA, Fuzhou 350025, China.
authors.forename: Xianming
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Otorhinolaryngology, Fuzong Clinical College of Fujian Medical University, Fuzhou General Hospital of Nanjing Command Zone of PLA, Fuzhou 350025, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Otorhinolaryngology, Fuzong Clinical College of Fujian Medical University, Fuzhou General Hospital of Nanjing Command Zone of PLA, Fuzhou 350025, China.
authors.forename: Hongxun
authors.initials: H
authors.lastname: Gong
authors.affiliation: Department of Otorhinolaryngology, Fuzong Clinical College of Fujian Medical University, Fuzhou General Hospital of Nanjing Command Zone of PLA, Fuzhou 350025, China.
authors.forename: Shiyan
authors.initials: S
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy; D009333:Neck / Q000473:pathology*; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055815:Young Adult