NPC: nodal grouping a significant prognostic factor

  • Liu Y & al.
  • Eur Radiol
  • 6 Dec 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Nodal grouping (NG), the presence of ≥3 contiguous lymph nodes (LNs) within 1 LN region, is associated with the survival outcomes of patients with nasopharyngeal carcinoma (NPC).

Why this matters

  • Prognostic factors are useful for guiding patient management.

Key results

  • NG was associated with OS (HR, 1.64; P=.011), PFS (HR, 1.62; P=.002), distant metastasis-free survival (DMFS; HR, 1.97; P=.001), and regional recurrence-free survival (HR, 1.62; P=.037) in multivariate analysis.
  • Upgrading patients with NG from stage N1 to stage N2 improved the C-index of the American Joint Committee on Cancer system for prediction of PFS (0.664 vs 0.658; P=.022) and DMFS (0.699 vs 0.690; P=.005).
  • In patients with NG and stage N1/2 disease, induction chemotherapy was associated with improved OS (P=.022), PFS (P=.007), and DMFS (P=.021).

Study design

  • 1224 patients with NPC were analyzed for the prognostic value of NG.
  • Funding: National Natural Science Foundation of China; Science and Technology Planning Project of Guangzhou City; Science and Technology Development Special Funds of Guangdong Province; Health & Medical Collaborative Innovation Project of Guangzhou City.

Limitations

  • No histological confirmation of metastatic LNs.
  • Retrospective study.