Prognostic value of MRI‐determined cervical lymph node size in nasopharyngeal carcinoma
Abstract Objectives To investigate the prognostic value of magnetic resonance imaging (MRI)‐determined cervical lymph node (CLN) size in nasopharyngeal carcinoma (NPC). Methods We retrospectively reviewed 2066 patients with NPC treated with intensity‐modulated radiotherapy, and randomly divided them...
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| Format: | Article |
| Language: | English |
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Wiley
2020-10-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.3392 |
| _version_ | 1797839430327730176 |
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| author | Cheng‐Long Huang Yang Chen Rui Guo Yan‐Ping Mao Cheng Xu Li Tian Li‐Zhi Liu Ai‐Hua Lin Ying Sun Jun Ma Ling‐long Tang |
| author_facet | Cheng‐Long Huang Yang Chen Rui Guo Yan‐Ping Mao Cheng Xu Li Tian Li‐Zhi Liu Ai‐Hua Lin Ying Sun Jun Ma Ling‐long Tang |
| author_sort | Cheng‐Long Huang |
| collection | DOAJ |
| description | Abstract Objectives To investigate the prognostic value of magnetic resonance imaging (MRI)‐determined cervical lymph node (CLN) size in nasopharyngeal carcinoma (NPC). Methods We retrospectively reviewed 2066 patients with NPC treated with intensity‐modulated radiotherapy, and randomly divided them into two groups, in a 1:1 ratio. One group was used for training (the training group), and the other one was for internal validation (the validation group). All patients had undergone MRI examination and the maximal axial diameters (MAD) of the axial plane of all positive nodes had been measured and recorded. Results Of 683 patients with CLN metastases in the training group (n = 1033), MAD = 4 cm was associated with worse OS (64.7% vs 84.6%, P < .001), DFS (55.9% vs 76.3%, P = .001), and DMFS (67.6% vs 86.1%, P = .001). Multivariate analysis showed that MAD = 4 cm was a significant negative prognostic factor for OS (HR = 2.058; P = .025), DFS (HR = 1.727; P = .049), and DMFS (HR = 2.034; P = .036). When MRI‐determined MAD = 4 cm was classified as N3 in the N classification, the OS, DFS, DMFS, and RRFS survival curves were well separated. The OS, DFS, DMFS, and RRFS concordance indexes were not statistically different between the proposed N staging system and the UICC/AJCC staging system in the training group, or between the training group and the validation group (all P = .05). Conclusion MAD = 4 cm on axial MRI slices can be recommended as a prognostic factor in future versions of the UICC/AJCC NPC staging system. |
| first_indexed | 2024-04-09T15:57:52Z |
| format | Article |
| id | doaj.art-f3ad6a18fba448da943645b4a02e8e53 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-09T15:57:52Z |
| publishDate | 2020-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-f3ad6a18fba448da943645b4a02e8e532023-04-25T14:00:49ZengWileyCancer Medicine2045-76342020-10-019197100710610.1002/cam4.3392Prognostic value of MRI‐determined cervical lymph node size in nasopharyngeal carcinomaCheng‐Long Huang0Yang Chen1Rui Guo2Yan‐Ping Mao3Cheng Xu4Li Tian5Li‐Zhi Liu6Ai‐Hua Lin7Ying Sun8Jun Ma9Ling‐long Tang10Department of Radiation Oncology State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat‐sen University Cancer Center Guangzhou ChinaDepartment of Radiation Oncology State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat‐sen University Cancer Center Guangzhou ChinaDepartment of Radiation Oncology State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat‐sen University Cancer Center Guangzhou ChinaDepartment of Radiation Oncology State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat‐sen University Cancer Center Guangzhou ChinaDepartment of Radiation Oncology State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat‐sen University Cancer Center Guangzhou ChinaImaging Diagnosis and Interventional Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat‐sen University Cancer Center Guangzhou ChinaImaging Diagnosis and Interventional Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat‐sen University Cancer Center Guangzhou ChinaDepartment of Medical Statistics and Epidemiology School of Public HealthSun Yat‐sen University Guangzhou ChinaDepartment of Radiation Oncology State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat‐sen University Cancer Center Guangzhou ChinaDepartment of Radiation Oncology State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat‐sen University Cancer Center Guangzhou ChinaDepartment of Radiation Oncology State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat‐sen University Cancer Center Guangzhou ChinaAbstract Objectives To investigate the prognostic value of magnetic resonance imaging (MRI)‐determined cervical lymph node (CLN) size in nasopharyngeal carcinoma (NPC). Methods We retrospectively reviewed 2066 patients with NPC treated with intensity‐modulated radiotherapy, and randomly divided them into two groups, in a 1:1 ratio. One group was used for training (the training group), and the other one was for internal validation (the validation group). All patients had undergone MRI examination and the maximal axial diameters (MAD) of the axial plane of all positive nodes had been measured and recorded. Results Of 683 patients with CLN metastases in the training group (n = 1033), MAD = 4 cm was associated with worse OS (64.7% vs 84.6%, P < .001), DFS (55.9% vs 76.3%, P = .001), and DMFS (67.6% vs 86.1%, P = .001). Multivariate analysis showed that MAD = 4 cm was a significant negative prognostic factor for OS (HR = 2.058; P = .025), DFS (HR = 1.727; P = .049), and DMFS (HR = 2.034; P = .036). When MRI‐determined MAD = 4 cm was classified as N3 in the N classification, the OS, DFS, DMFS, and RRFS survival curves were well separated. The OS, DFS, DMFS, and RRFS concordance indexes were not statistically different between the proposed N staging system and the UICC/AJCC staging system in the training group, or between the training group and the validation group (all P = .05). Conclusion MAD = 4 cm on axial MRI slices can be recommended as a prognostic factor in future versions of the UICC/AJCC NPC staging system.https://doi.org/10.1002/cam4.3392lymph nodemagnetic resonanceN staging systemnasopharyngeal carcinomaprognosis |
| spellingShingle | Cheng‐Long Huang Yang Chen Rui Guo Yan‐Ping Mao Cheng Xu Li Tian Li‐Zhi Liu Ai‐Hua Lin Ying Sun Jun Ma Ling‐long Tang Prognostic value of MRI‐determined cervical lymph node size in nasopharyngeal carcinoma Cancer Medicine lymph node magnetic resonance N staging system nasopharyngeal carcinoma prognosis |
| title | Prognostic value of MRI‐determined cervical lymph node size in nasopharyngeal carcinoma |
| title_full | Prognostic value of MRI‐determined cervical lymph node size in nasopharyngeal carcinoma |
| title_fullStr | Prognostic value of MRI‐determined cervical lymph node size in nasopharyngeal carcinoma |
| title_full_unstemmed | Prognostic value of MRI‐determined cervical lymph node size in nasopharyngeal carcinoma |
| title_short | Prognostic value of MRI‐determined cervical lymph node size in nasopharyngeal carcinoma |
| title_sort | prognostic value of mri determined cervical lymph node size in nasopharyngeal carcinoma |
| topic | lymph node magnetic resonance N staging system nasopharyngeal carcinoma prognosis |
| url | https://doi.org/10.1002/cam4.3392 |
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