Tham Ivan Weng-Keong, Hee Siew Wan, Yap Swee Peng, Tuan Jeffrey Kit-Loong, Wee Joseph
Department of Radiation Oncology, National Cancer Centre, Singapore.
Head Neck. 2009 Apr;31(4):468-74. doi: 10.1002/hed.21008.
Retropharyngeal lymph node (RLN) staging in nasopharyngeal carcinoma (NPC) can be controversial.
We retrospectively reviewed all patients with T(2-4), N(0-1) NPC treated between 1992 and 1994 to examine if RLN metastasis resulted in an increased incidence of distant metastases.
Of the 667 patients with NPC, 395 had T(2-4), N(0-1) disease, 140 had N(0), and 255 had N(1). All had staging CT scans and were treated with radiotherapy. Median follow-up was 8.3 years. Seventy-four percent showed undifferentiated histology. In this cohort, 187 (47%) had RLN metastases. Multivariate analysis showed that RLN conferred a higher hazard for distant metastasis (p = .04). Using the Kaplan-Meier method, patients with N(0) disease and RLN had a similar hazard for distant metastases as patients with N(1) disease when compared with patients with N(0) disease and without RLN.
Patients with N(0) disease and RLN appear to share a similar prognosis to patients with N(1) disease.
鼻咽癌（NPC）的咽后淋巴结（RLN）分期可能存在争议。
我们回顾性分析了1992年至1994年间接受治疗的所有T（2 - 4）、N（0 - 1）期鼻咽癌患者，以研究RLN转移是否会导致远处转移发生率增加。
667例鼻咽癌患者中，395例为T（2 - 4）、N（0 - 1）期疾病，140例为N（0）期，255例为N（1）期。所有患者均进行了分期CT扫描并接受了放疗。中位随访时间为8.3年。74%的患者组织学表现为未分化型。在该队列中，187例（47%）有RLN转移。多因素分析显示，RLN转移使远处转移风险更高（p = 0.04）。采用Kaplan - Meier方法，与无RLN转移的N（0）期患者相比，有RLN转移的N（0）期患者发生远处转移的风险与N（1）期患者相似。
有RLN转移的N（0）期患者似乎与N（1）期患者有相似的预后。
