ArticleCell reports. Medicine2025
Advanced image-identified extranodal extension of retropharyngeal lymph nodes in the refinement of N classification for nasopharyngeal carcinoma.
Article in Cell reports. Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07088861 (Validation and Analysis of the 9th Edition AJCC/UICC Staging System for Nasopharyngeal Carcinoma in Non-High-Incidence Areas in China - A Multicentre Retrospective Clinical Study), which is not on this map. Cited by 5 papers.
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The trial behind it
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Validation and Analysis of the 9th Edition AJCC/UICC Staging System for Nasopharyngeal Carcinoma in Non-High-Incidence Areas in China - A Multicentre Retrospective Clinical Study
Who cites it
5 citing papers in PubMed.
- Validation and refinement of the N classification for nasopharyngeal carcinoma based on the 9th version AJCC/UICC TNM staging system in non-endemic regions of China: a multicenter cohort study.Clinical and translational radiation oncology · 2027Article
- MRI-based assessment of tumor aggressiveness in nasopharyngeal carcinoma: risk stratification and survival prediction.European radiology · 2026Article
- Validation of the 9th Edition of the Tumor-Node-Metastasis Staging System for Non-Metastatic Nasopharyngeal Carcinoma: A Multicenter Retrospective Analysis From High-Incidence Regions.Cancer medicine · 2026Article
- Risk stratification of advanced extranodal extension in retropharyngeal lymph nodes for nasopharyngeal carcinoma: a multi-center study.Cancer imaging : the official publication of the International Cancer Imaging Society · 2026Article
- Recent AJCC Version 9 Staging of Nasopharyngeal Cancer.Journal of the Korean Society of Radiology · 2026Review
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24 authors.
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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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