Prognostic value of cervical nodal necrosis on staging imaging of nasopharyngeal carcinoma in era of intensity-modulated radiotherapy: a systematic review and meta-analysis

Ai, Qi Yong H.; Hung, Kuo Feng; So, Tiffany Y.; Mo, Frankie; Chin, Wing Tsung Anthony; Hui, Edwin P.; Brigette, B.; Ying, Michael; King, Ann D.

doi:10.1186/s40644-022-00462-6

Cited by 9 publications

(1 citation statement)

References 45 publications

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“…The incidence rate of LNN in stage N1-3 NPC patients was 32.4% in this study, similar to 23-42% reported in previous studies 8 , 26 - 27 . This study further evaluated the incidence of LNN at different N stages, that was 25.1% with N1, 47.9% with N2, and 52.7% with N3.…”

Section: Discussionsupporting

confidence: 90%

Prognostic Value of Lymph Node Necrosis at Different N Stages in Patients with Nasopharyngeal Carcinoma

Fu¹,

Liang²,

Huang³

et al. 2023

J. Cancer

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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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Section: Discussionsupporting

confidence: 90%

Prognostic Value of Lymph Node Necrosis at Different N Stages in Patients with Nasopharyngeal Carcinoma

Fu¹,

Liang²,

Huang³

et al. 2023

J. Cancer

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Machine learning‐derived prognostic signature for progression‐free survival in non‐metastatic nasopharyngeal carcinoma

Zuo,

Ma,

Yan

et al. 2024

Head & Neck

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BackgroundEarly detection of high‐risk nasopharyngeal carcinoma (NPC) recurrence is essential. We created a machine learning‐derived prognostic signature (MLDPS) by combining three machine learning (ML) models to predict progression‐free survival (PFS) in patients with non‐metastatic NPC.MethodsA cohort of 653 patients with non‐metastatic NPC was divided into a training (n = 457) and validation (n = 196) dataset (7:3 ratio). The study included clinicopathological characteristics, hematologic markers, and MRI findings in three machine learning models—random forest (RF), extreme gradient boosting (XGBoost), and least absolute shrinkage and selection operator (LASSO)—to predict progression‐free survival (PFS). A Venn diagram identified the overlapping signatures from the three ML algorithms. Cox proportional hazard analysis determined the MLDPS for PFS.ResultsThe RF, XGBoost, and LASSO algorithms identified six consensus factors from the 33 signatures. Cox proportional hazards analysis showed that the MLDPS includes age, lymphocyte count, number of positive lymph nodes, and regional lymph node density. Additionally, MLDPS effectively stratified prognosis, with low‐risk individuals showing better PFS than high‐risk individuals (p < 0.001).ConclusionMLDPS, based on clinicopathological characteristics, hematologic markers, and MRI findings, is crucial for guiding clinical management and personalizing treatments for patients with non‐metastatic NPC.

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Efficacy of induction chemotherapy in lymph node-positive stage III nasopharyngeal carcinoma and identification of beneficiaries based on clinical features: A propensity score matching analysis

Xu,

Chen,

Liang

et al. 2023

Oral Oncology

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Prognostic value of cervical nodal necrosis on staging imaging of nasopharyngeal carcinoma in era of intensity-modulated radiotherapy: a systematic review and meta-analysis

Cited by 9 publications

References 45 publications

Prognostic Value of Lymph Node Necrosis at Different N Stages in Patients with Nasopharyngeal Carcinoma

Prognostic Value of Lymph Node Necrosis at Different N Stages in Patients with Nasopharyngeal Carcinoma

Machine learning‐derived prognostic signature for progression‐free survival in non‐metastatic nasopharyngeal carcinoma

Efficacy of induction chemotherapy in lymph node-positive stage III nasopharyngeal carcinoma and identification of beneficiaries based on clinical features: A propensity score matching analysis

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