{"title":"Advanced image-identified extranodal extension of retropharyngeal lymph nodes in the refinement of N classification for nasopharyngeal carcinoma.","authors":"Wei Jiang, Gao-Yuan Wang, Guan-Jie Qin, Wu-Qi Zhang, Xiao-Dong Zhu, Ya-Qian Han, Feng Lei, Liang-Fang Shen, Kun-Yu Yang, Chun-Yan Cui, Ling-Long Tang, Yan-Ping Mao, Lei Chen, Rui Guo, Ling Li, Zheng Wu, Gui-Qiong Xu, Qin Zhou, Jing Huang, Shao-Hui Huang, Ji-Bin Li, Li-Zhi Liu, Jun Ma, Xiao-Jing Du","doi":"10.1016/j.xcrm.2025.101942","DOIUrl":null,"url":null,"abstract":"<p><p>Advanced extranodal extension (ENE) in cervical lymph nodes (CLNs) increases the risk of distant metastasis in nasopharyngeal carcinoma (NPC). The 9th NPC staging system classifies N1/N2 patients with advanced CLN ENE as N3 due to similar outcomes. However, the prognostic impact of advanced ENE in retropharyngeal lymph nodes (RLNs) remains unclear. In this study of 4,485 patients with non-metastatic NPC, N1/N2 patients with advanced RLN ENE demonstrate better 5-year overall survival (hazard ratio [HR]: 0.60, 95% confidence interval [CI]: 0.38-0.93; HR: 0.57, 95% CI: 0.32-1.00) and failure-free survival (HR: 0.63, 95% CI: 0.44-0.92; HR: 0.52, 95% CI: 0.31-0.86) than N3 patients. Advanced RLN ENE shows a positive correlation with other RLN-related anatomical factors and is not identified as an independent prognostic factor. External validation in 3,849 patients from five centers supports these findings. Based on this evidence, upgrading advanced RLN ENE to N3 is not advised.</p>","PeriodicalId":9822,"journal":{"name":"Cell Reports Medicine","volume":" ","pages":"101942"},"PeriodicalIF":11.7000,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cell Reports Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.xcrm.2025.101942","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/11 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CELL BIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Advanced extranodal extension (ENE) in cervical lymph nodes (CLNs) increases the risk of distant metastasis in nasopharyngeal carcinoma (NPC). The 9th NPC staging system classifies N1/N2 patients with advanced CLN ENE as N3 due to similar outcomes. However, the prognostic impact of advanced ENE in retropharyngeal lymph nodes (RLNs) remains unclear. In this study of 4,485 patients with non-metastatic NPC, N1/N2 patients with advanced RLN ENE demonstrate better 5-year overall survival (hazard ratio [HR]: 0.60, 95% confidence interval [CI]: 0.38-0.93; HR: 0.57, 95% CI: 0.32-1.00) and failure-free survival (HR: 0.63, 95% CI: 0.44-0.92; HR: 0.52, 95% CI: 0.31-0.86) than N3 patients. Advanced RLN ENE shows a positive correlation with other RLN-related anatomical factors and is not identified as an independent prognostic factor. External validation in 3,849 patients from five centers supports these findings. Based on this evidence, upgrading advanced RLN ENE to N3 is not advised.
Cell Reports MedicineBiochemistry, Genetics and Molecular Biology-Biochemistry, Genetics and Molecular Biology (all)
CiteScore
15.00
自引率
1.40%
发文量
231
审稿时长
40 days
期刊介绍:
Cell Reports Medicine is an esteemed open-access journal by Cell Press that publishes groundbreaking research in translational and clinical biomedical sciences, influencing human health and medicine.
Our journal ensures wide visibility and accessibility, reaching scientists and clinicians across various medical disciplines. We publish original research that spans from intriguing human biology concepts to all aspects of clinical work. We encourage submissions that introduce innovative ideas, forging new paths in clinical research and practice. We also welcome studies that provide vital information, enhancing our understanding of current standards of care in diagnosis, treatment, and prognosis. This encompasses translational studies, clinical trials (including long-term follow-ups), genomics, biomarker discovery, and technological advancements that contribute to diagnostics, treatment, and healthcare. Additionally, studies based on vertebrate model organisms are within the scope of the journal, as long as they directly relate to human health and disease.