Prognostic significance of cystic lymph nodal metastasis in nasopharyngeal carcinoma

Head Neck. 2017 Sep;39(9):1832-1839. doi: 10.1002/hed.24844. Epub 2017 Jun 22.

Abstract

Background: The purpose of this study was to determine the prevalence of cystic lymph nodal metastasis (CLNM) and its prognostic value in patients with nasopharyngeal carcinoma (NPC).

Methods: A retrospective review was conducted on 257 patients with NPC, analyzing the presence of CLNM on MRI or CT scans. Oncologic outcomes were performed using the Kaplan-Meier analysis.

Results: One hundred eleven patients (43.2%) had CLNM at diagnosis. Overall, patients with CLNM had a poorer disease-specific survival (DSS; P < .001) and overall survival (OS; P < .001) compared with patients without CLNM. When analyzed according to nodal status, CLNM was associated with a higher rate of distant metastasis recurrence (P = .007), a poorer DSS (P < .001), and a poorer OS (P < .001) among patients with N2 disease.

Conclusion: The prevalence of CLNM was 43.2%. In patients with N2 disease, the presence of CLNM was significantly associated with a poorer DSS, OS, and increased risk of distant metastasis recurrence.

Keywords: cystic lymph nodal metastasis; disease-specific survival; head and neck cancer; nasopharyngeal carcinoma; prognostic factor.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Carcinoma / diagnostic imaging
  • Carcinoma / mortality*
  • Carcinoma / pathology*
  • Cause of Death*
  • China
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nasopharyngeal Carcinoma
  • Nasopharyngeal Neoplasms / diagnostic imaging
  • Nasopharyngeal Neoplasms / mortality*
  • Nasopharyngeal Neoplasms / pathology*
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Tomography, X-Ray Computed / methods