High-grade radiologic extra-nodal extension predicts distant metastasis in stage II nasopharyngeal carcinoma
Yujun Hu1, Tianzhu Lu1, Shao Hui Huang2
1Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fuzhou, China.
Background:
To investigate the prognostic value of radiologic extra-nodal extension (rENE) in stage II nasopharyngeal carcinoma (NPC).
Methods:
Stage II NPC patients with N1 category (n = 365) were enrolled and divided into three groups according to the situation of rENE: without rENE, suspected rENE, and confirmed rENE (grades: A, infiltration into surrounding fat; B, matted nodes; C, infiltration into adjacent structures).
Results:
Only high-grade rENE (including matted nodes and infiltration into adjacent structures) could significantly influence the survival outcomes, patients with high-grade rENE had significantly poorer survival than those without, with the 7-year distant metastasis-free survival and overall survival demonstrated to be 78.5% vs 93.0% (P < .001) and 81.9% vs 89.9% (P = .05), respectively. High-grade rENE, as defined in our study, is a stable criterion, with high intra-rater and inter-rater consistency.
Conclusion:
High-grade rENE was an evaluable predictor that could help with the selection of stage II patients with high risk of distant metastasis.
Related Concept Videos
Nodal Analysis
Consider, for instance, a simple circuit composed of three nodes and three resistors, as shown in...
Suctioning the Nasopharyngeal Airway
Equipment Required
Nodal Analysis with Voltage Sources
Consider a circuit that contains four resistors and two voltage sources, as shown in Figure 1. One of these voltage sources is connected between a...
Graded Potential
Graded potentials fall into two categories: depolarizing and hyperpolarizing. Depolarizing graded potentials typically occur when sodium (Na+) or...
Radiological Investigation I: X-ray and CT
Metastasis
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...


