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Staging computed tomography of the thorax for nasopharyngeal carcinoma
Author(s) -
Leung Singfai,
Cheung Humairah,
Teo Peter,
Lam Wynnie Waiman
Publication year - 2000
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/1097-0347(200007)22:4<369::aid-hed9>3.0.co;2-2
Subject(s) - thorax (insect anatomy) , medicine , mediastinum , nasopharyngeal carcinoma , radiology , carcinoma , stage (stratigraphy) , radiation therapy , metastasis , supraclavicular lymph nodes , nodal , cancer , pathology , anatomy , paleontology , biology
Background To assess the role of staging CT of the thorax in advanced nodal stage nasopharyngeal carcinoma and to examine the hypothesis that contiguous spread of nodal metastases from the supraclavicular region to the upper mediastinal region occurs in this cancer. Methods Forty‐four patients with newly diagnosed nasopharyngeal carcinoma with neck node metastases to the supraclavicular region (ie, AJCC N3b stage) underwent contrast‐enhanced CT (CECT) thorax for staging. CT findings and clinical outcome were analyzed. Results No patient was found to have intrathoracic metastasis, although 1 had hepatic metastases on CECT of the thorax, resulting in upstaging in 1 of 44 (2%) of patients. With a median follow‐up time of 21 months, 3 patients had lung metastases and 2 had axillary nodal metastases develop without evidence of upper mediastinal nodal metastases. Conclusion Staging CECT of the thorax has a very low yield in nasopharyngeal carcinoma, even in advanced nodal disease. The hypothesis that contiguous spread of nodal metastases from the supraclavicular region to the upper mediastinum is not substantiated, and no evidence suggests that radiation therapy for N3b‐stage disease needs to encompass the upper mediastinum. © 2000 John Wiley & Sons, Inc. Head Neck 22: 369–372, 2000.