Evidence map›Paper›PMID 41632574›Full record

ArticleClinical nuclear medicine2026

Refining M1-Stage Stratification in De Novo Metastatic Nasopharyngeal Carcinoma Using 18F-FDG PET/CT: Preliminary Evidence.

Sean Hsiang-Ting Chen, Nai-Ming Cheng, Kang-Shing Fan, Po-Hung Chang, Li-Ang Lee, Shiang-Fu Huang, Chung-Jan Kang, Eric Yi-Liang Shen, Kai-Ping Chang, Pei-Wen Wu and 4 more

Abstract read
In one paragraph

Article in Clinical nuclear medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Survival and patterns of recurrence in patients with nasopharyngeal carcinoma from a non-endemic region-A German multicenter analysis.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Sean Hsiang-Ting ChenDepartment of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan.
Nai-Ming ChengDepartment of Nuclear Medicine, Keelung Chang Gung Memorial Hospital, Keelung.
Kang-Shing FanDepartment of Radiation Oncology, Tu-Shen Chang Gung Memorial Hospital, New Taipei.ORCID 0000-0002-0910-7803
Po-Hung ChangDepartment of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan.ORCID 0000-0001-8725-6209
Li-Ang LeeDepartment of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan.ORCID 0000-0001-8414-595
Shiang-Fu HuangDepartment of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan.
Chung-Jan KangDepartment of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan.ORCID 0000-0002-5333-9396
Eric Yi-Liang ShenDepartment of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan.ORCID 0000-0003-2910-1393
Kai-Ping ChangDepartment of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan.ORCID 0000-0003-1777-9578
Pei-Wen WuDepartment of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan.
Kuang-Hsu LienDepartment of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan.
Tuan-Jen FangDepartment of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan.
Ann-Joy ChengDepartment of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Joseph Tung-Chieh ChangDepartment of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo validate the American Joint Committee on Cancer (AJCC) 9th edition M1-stage subdivision for de novo metastatic nasopharyngeal carcinoma (DM-NPC) and explore preliminary evidence for a refined classification using 18F-FDG positron emission tomography/computed tomography (PET/CT)-derived metastatic burden. PATIENTS AND

methodsA retrospective cohort of 185 DM-NPC patients diagnosed between 2000 and 2022, who underwent pretreatment 18F-FDG PET/CT, was analyzed. Recursive partitioning analysis (RPA) identified prognostic cutoffs for metastatic lesions. Survival outcomes were compared between AJCC 9th edition M1 subgroups (M1a: ≤3 lesions; M1b: >3 lesions) and a redefined PET-based classification (Rd-M1a: single-organ, ≤4 lesions; Rd-M1b: >5 lesions or multiorgan).

resultsPatients with single-organ metastases and ≤4 lesions showed potentially superior overall survival (OS) (2-y OS: 60.4% vs. 29.0%; 3-y OS: 46.2% vs. 19.6%; P<0.001). Higher metastatic burden (>5 lesions) was independently associated with worse OS (HR: 1.81; 95% CI: 1.24-2.64; P=0.002). The redefined classification suggested better prognostic discrimination than the AJCC 9th edition (C-index: 0.594 vs. 0.562; AUC at 36 mo: 0.649 vs. 0.598). Patients classified as Rd-M1b had a significantly unfavorable OS compared with those in the Rd-M1a group (HR: 2.02, 95% CI: 1.39-2.92; P=0.002).

conclusionsThese preliminary findings suggest that 18F-FDG PET/CT may enhance M1-stage stratification by quantifying metastatic burden and distribution in patients with DM-NPC, potentially offering improved prognostic accuracy. However, as a single-institution retrospective study, external validation is essential to confirm these observations and guide personalized treatment strategies.

Indexed as

Fluorodeoxyglucose F18Nasopharyngeal CarcinomaNasopharyngeal NeoplasmsPositron Emission Tomography Computed TomographyAdultAgedFemaleHumansMaleMiddle AgedNeoplasm MetastasisNeoplasm StagingPrognosisRetrospective StudiesFluorodeoxyglucose F1818F-FDG PET/CTAJCC 9th editionde novo metastasisM1-stage stratificationnasopharyngeal carcinomaoligometastatic disease

Identifiers

PMID41632574
PMCPMC12871420

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.