Retropharyngeal nodal metastasis related to higher rate of distant metastasis in patients with N0 and N1 nasopharyngeal cancer

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Abstract
Background: Retropharyngeal lymph node (RLN) staging in nasopharyngeal carcinoma (NPC) can be controversial.Methods: We retrospectively reviewed all patients with T2–4, N0–1 NPC treated between 1992 and 1994 to examine if RLN metastasis resulted in an increased incidence of distant metastases.Results: Of the 667 patients with NPC, 395 had T2–4, N0–1 disease, 140 had N0, and 255 had N1. All had staging CT scans and were treated with radiotherapy. Median follow‐up was 8.3 years. Seventy‐four percent showed undifferentiated histology. In this cohort, 187 (47%) had RLN metastases. Multivariate analysis showed that RLN conferred a higher hazard for distant metastasis (p = .04). Using the Kaplan–Meier method, patients with N0 disease and RLN had a similar hazard for distant metastases as patients with N1 disease when compared with patients with N0 disease and without RLN.Conclusion: Patients with N0 disease and RLN appear to share a similar prognosis to patients with N1 disease. © 2009 Wiley Periodicals, Inc. Head Neck, 2009

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