Article: Management of extensive cervical nodal metastasis in nasopharyngeal carcinoma after radiotherapy: A clinicopathological study

File Download Links for fulltext
(May Require Subscription)
Supplementary
  • Basic View
  • Metadata View
  • XML View
TitleManagement of extensive cervical nodal metastasis in nasopharyngeal carcinoma after radiotherapy: A clinicopathological study
AuthorsWei, WI1
Ho, WK1
Cheng, ACK1
Wu, X1
Li, GKH1
Nicholls, J1
Yuen, PW1
Sham, JST1
Issue Date2001
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archoto.com
CitationArchives Of Otolaryngology - Head And Neck Surgery, 2001, v. 127 n. 12, p. 1457-1462 [How to Cite?]
AbstractObjectives: To evaluate the efficacy of afterloading brachytherapy following radical neck dissection (RND) in the management of extensive cervical lymph node disease in nasopharyngeal carcinoma after radiotherapy; and to examine prospectively prognostic factors and the pathologic behavior of neck disease. Patients: Twenty-seven patients with nasopharyngeal carcinoma who had extensive cervical lymph node metastasis following external radiotherapy were treated with RND. Thirteen of them also underwent afterloading brachytherapy with iridium wire (Ir 192). The RND specimens of the 27 patients were also examined with step serial whole-specimen sectioning. Results: All patients survived and their wounds healed primarily. Pathologic examination revealed 183 tumorbearing lymph nodes that contained tumors in the neck: level I, 4% (8/183); level II, 53% (96/183); level III, 34% (62/183); level IV, 5% (9/183); and level V, 4% (8/183). Extracapsular tumor extension was seen in 84% of patients. Multivariate analysis identified the number of tumor-bearing lymph nodes detected in the specimens to be the only significant factor that affected control of disease. Although the neck disease in the group of patients who had afterloading brachytherapy was more extensive, the 3-year actuarial tumor control for the groups with and without brachytherapy were 60% and 61%, respectively. Conclusions: Recurrent cervical lymph nodes after radiotherapy in nasopharyngeal carcinoma are extensive and RND is mandatory for a successful salvage. When the nodal metastasis infiltrate or adhere to surrounding tissue, afterloading brachytherapy with iridium wire can provide satisfactory local tumor control.
ISSN0886-4470
2011 Impact Factor: 1.63
2011 SCImago Journal Rankings: 0.098
ISI Accession Number IDWOS:000172657600006
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorWei, WI
dc.contributor.authorHo, WK
dc.contributor.authorCheng, ACK
dc.contributor.authorWu, X
dc.contributor.authorLi, GKH
dc.contributor.authorNicholls, J
dc.contributor.authorYuen, PW
dc.contributor.authorSham, JST
dc.date.accessioned2010-09-06T09:45:51Z
dc.date.available2010-09-06T09:45:51Z
dc.date.issued2001
dc.description.abstractObjectives: To evaluate the efficacy of afterloading brachytherapy following radical neck dissection (RND) in the management of extensive cervical lymph node disease in nasopharyngeal carcinoma after radiotherapy; and to examine prospectively prognostic factors and the pathologic behavior of neck disease. Patients: Twenty-seven patients with nasopharyngeal carcinoma who had extensive cervical lymph node metastasis following external radiotherapy were treated with RND. Thirteen of them also underwent afterloading brachytherapy with iridium wire (Ir 192). The RND specimens of the 27 patients were also examined with step serial whole-specimen sectioning. Results: All patients survived and their wounds healed primarily. Pathologic examination revealed 183 tumorbearing lymph nodes that contained tumors in the neck: level I, 4% (8/183); level II, 53% (96/183); level III, 34% (62/183); level IV, 5% (9/183); and level V, 4% (8/183). Extracapsular tumor extension was seen in 84% of patients. Multivariate analysis identified the number of tumor-bearing lymph nodes detected in the specimens to be the only significant factor that affected control of disease. Although the neck disease in the group of patients who had afterloading brachytherapy was more extensive, the 3-year actuarial tumor control for the groups with and without brachytherapy were 60% and 61%, respectively. Conclusions: Recurrent cervical lymph nodes after radiotherapy in nasopharyngeal carcinoma are extensive and RND is mandatory for a successful salvage. When the nodal metastasis infiltrate or adhere to surrounding tissue, afterloading brachytherapy with iridium wire can provide satisfactory local tumor control.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationArchives Of Otolaryngology - Head And Neck Surgery, 2001, v. 127 n. 12, p. 1457-1462 [How to Cite?]
dc.identifier.epage1462
dc.identifier.hkuros66025
dc.identifier.isiWOS:000172657600006
dc.identifier.issn0886-4470
2011 Impact Factor: 1.63
2011 SCImago Journal Rankings: 0.098
dc.identifier.issue12
dc.identifier.openurl
dc.identifier.pmid11735814
dc.identifier.scopuseid_2-s2.0-0035215882
dc.identifier.spage1457
dc.identifier.urihttp://hdl.handle.net/10722/88626
dc.identifier.volume127
dc.languageeng
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archoto.com
dc.publisher.placeUnited States
dc.relation.ispartofArchives of Otolaryngology - Head and Neck Surgery
dc.relation.referencesReferences in Scopus
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshBrachytherapy
dc.subject.meshCarcinoma - mortality - pathology - radiotherapy - therapy
dc.subject.meshCombined Modality Therapy
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshIridium Radioisotopes - therapeutic use
dc.subject.meshLymphatic Metastasis
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshNasopharyngeal Neoplasms - mortality - pathology - radiotherapy - therapy
dc.subject.meshNeck
dc.subject.meshNeck Dissection
dc.subject.meshPrognosis
dc.subject.meshProspective Studies
dc.subject.meshSurvival Rate
dc.titleManagement of extensive cervical nodal metastasis in nasopharyngeal carcinoma after radiotherapy: A clinicopathological study
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong