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@ARTICLE{Fu:277796,
      author       = {Y.-C. Fu and S.-B. Liang and W.-J. Huang and L.-S. Chen and
                      D.-M. Chen$^*$ and L.-Z. Liu and M. Luo and X.-F. Zhong and
                      X.-Y. Xu},
      title        = {{P}rognostic {V}alue of {L}ymph {N}ode {N}ecrosis at
                      {D}ifferent {N} {S}tages in {P}atients with {N}asopharyngeal
                      {C}arcinoma.},
      journal      = {Journal of cancer},
      volume       = {14},
      number       = {11},
      issn         = {1837-9664},
      address      = {Wyoming, NSW},
      publisher    = {Ivyspring Internat. Publ.},
      reportid     = {DKFZ-2023-01507},
      pages        = {2085 - 2092},
      year         = {2023},
      abstract     = {Background: Lymph node necrosis (LNN), including
                      retropharyngeal nodal necrosis and cervical nodal necrosis,
                      which is related to radiotherapy/ chemotherapy resistance,
                      is a common phenomenon in nasopharyngeal carcinoma (NPC).
                      This study was to assess the prognostic value of LNN at
                      different N stages in NPC patients. Materials and Methods:
                      In total, 1,665 newly diagnosed NPC patients at stage
                      TxN1-3M0 from two centers were enrolled. Univariate and
                      multivariate models were constructed to assess the
                      association between LNN and long-term survival outcomes. The
                      propensity score matching method was performed to balance
                      treatment groups for baseline characteristics. Results: Of
                      the 1,665, 540 patients (540/1665, $32.4\%)$ were diagnosed
                      with LNN, of which $54.1\%$ (292/540) patients were at stage
                      N1, $31.3\%$ (169/540) at stage N2, and $14.6\%$ (79/540) at
                      stage N3. Univariate and multivariate analyses indicated LNN
                      as an independent predictor for progression‑free survival
                      (PFS), overall survival (OS), distant metastasis-free
                      survival (DMFS), and locoregional relapse-free survival
                      (LRRFS) in stage N1-3 patients (all P<0.001). When patients
                      were analyzed according to stage, similar findings were
                      observed for N1 patients (all P<0.001); for N2 patients, LNN
                      independently predicted PFS (P=0.003), OS (P=0.011), and
                      DMFS (P=0.004), and for stage N3, LNN only independently
                      predicted LRRFS (P=0.019). 123 pairs of patients who
                      received induction chemotherapy plus concurrent
                      chemoradiotherapy or only concurrent chemoradiotherapy were
                      matched, adding induction chemotherapy improved 5-year OS,
                      PFS and LRFFS, but the results were not statistically
                      significant. Conclusions: In NPC patients, LNN could
                      independently predict poor prognosis at all N1-3 stages and
                      at each N stage (N1 to N3). The value of adding induction
                      chemotherapy to concurrent chemoradiotherapy in patients
                      with LNN still requires further prospective studies.},
      keywords     = {induction chemotherapy (Other) / lymph node necrosis
                      (Other) / nasopharyngeal carcinoma (Other) / prognosis
                      (Other) / stage N1-3 (Other)},
      cin          = {E055},
      ddc          = {610},
      cid          = {I:(DE-He78)E055-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37497418},
      pmc          = {pmc:PMC10367925},
      doi          = {10.7150/jca.84854},
      url          = {https://inrepo02.dkfz.de/record/277796},
}