Home > Publications database > Prognostic Value of Lymph Node Necrosis at Different N Stages in Patients with Nasopharyngeal Carcinoma. > print

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024 7 _ |a 10.7150/jca.84854
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100 1 _ |a Fu, Yue-Chun
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245 _ _ |a Prognostic Value of Lymph Node Necrosis at Different N Stages in Patients with Nasopharyngeal Carcinoma.
260 _ _ |a Wyoming, NSW
|c 2023
|b Ivyspring Internat. Publ.
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520 _ _ |a 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.
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650 _ 7 |a induction chemotherapy
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650 _ 7 |a lymph node necrosis
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650 _ 7 |a nasopharyngeal carcinoma
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650 _ 7 |a prognosis
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650 _ 7 |a stage N1-3
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700 1 _ |a Liang, Shao-Bo
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700 1 _ |a Huang, Wen-Jie
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700 1 _ |a Chen, Lu-Si
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700 1 _ |a Chen, Dan-Ming
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700 1 _ |a Liu, Li-Zhi
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700 1 _ |a Luo, Min
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700 1 _ |a Zhong, Xiao-Fen
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700 1 _ |a Xu, Xiang-Ying
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773 _ _ |a 10.7150/jca.84854
|g Vol. 14, no. 11, p. 2085 - 2092
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