Advanced image-identified extranodal extension of retropharyngeal lymph nodes in the refinement of N classification for nasopharyngeal carcinoma.

IF 11.7 1区医学 Q1 CELL BIOLOGY

Cell Reports Medicine Pub Date : 2025-02-18 Epub Date: 2025-02-11 DOI:10.1016/j.xcrm.2025.101942

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

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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.

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先进的图像识别咽后淋巴结结外延伸在鼻咽癌N分类的改进。

颈部淋巴结（cln）的晚期结外延伸（ENE）增加鼻咽癌（NPC）远处转移的风险。第9个NPC分期系统将晚期CLN ENE的N1/N2患者分类为N3，因为结果相似。然而，晚期ENE对咽后淋巴结（RLNs）的预后影响尚不清楚。在这项4,485例非转移性鼻咽癌患者的研究中，N1/N2晚期RLN ENE患者表现出更好的5年总生存率(风险比[HR]: 0.60, 95%可信区间[CI]: 0.38-0.93；HR: 0.57, 95% CI: 0.32-1.00)和无失败生存率(HR: 0.63, 95% CI: 0.44-0.92；HR: 0.52, 95% CI: 0.31-0.86)。晚期RLN ENE与其他与RLN相关的解剖学因素呈正相关，未被确定为独立的预后因素。来自五个中心的3849名患者的外部验证支持这些发现。基于此证据，不建议将高级RLN ENE升级为N3。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cell Reports Medicine Biochemistry, 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.