ArticleCancer medicine2026
Upper Versus Middle-Neck Involvement in TNM-9 Stage IB Nasopharyngeal Carcinoma: Implications for De-Escalation and Intensification Strategies.
Article in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.
What it found
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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.
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.
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Who cites it
1 citing paper in PubMed.
Corrections and comments
- Erratum issued
Authors and funding
14 authors.
Funding
Abstract
backgroundTNM-9 Stage IB nasopharyngeal carcinoma (NPC) encompasses markedly heterogeneous risk profiles, yet lacks reliable biomarkers to guide the choice between de-escalation and intensification strategies. This study aimed to explore the prognostic significance of upper- and middle-neck nodal involvement (UNI and MNI) in this population and how it affects treatment outcomes and prognosis.
methodsPatients with Stage IB NPC treated between June 2016 and December 2019 at our institution were included. Nodal levels were classified into UNI and MNI. Survival outcomes, including overall survival (OS), progression-free survival (PFS), distant control (DC), and regional control (RC), were analyzed.
resultsA total of 370 patients were analyzed, with 257 (69.5%) classified in the UNI group and 113 (30.5%) in the MNI group, respectively. MNI was found to be associated with significantly worse prognosis compared to UNI. Specifically, the MNI group had lower 5-year OS (91.1% vs. 98.8%, p < 0.001), PFS (78.6% vs. 95.6%, p < 0.001), DC (90.2% vs. 98.8%, p < 0.001), and RC (93.3% vs. 98.4%, p = 0.005) than the UNI group. Association analysis revealed that nodal level was significantly associated with other known adverse prognostic factors, including the maximum diameter of positive lymph nodes, matted nodes, and high EBV-DNA levels (all p < 0.001). Crucially, after multivariate adjustment, nodal level is the only independent prognostic factor.
conclusionThe nodal level was a critical factor in predicting patient outcomes in Stage IB NPC. These findings are hypothesis-generating: UNI patients may represent a candidate population for prospective de-escalation trials, whereas MNI patients may warrant evaluation of intensified or novel strategies in future studies. Prospective validation is required before any change in clinical management.
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