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Prognostic impact of magnetic resonance imaging‐detected cranial nerve involvement in nasopharyngeal carcinoma
Author(s) -
Liu Lizhi,
Liang Shaobo,
Li Li,
Mao Yanping,
Tang Linglong,
Tian Li,
Liao Xinbiao,
Cui Chunyan,
Lin Aihua,
Ma Jun
Publication year - 2009
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.24201
Subject(s) - medicine , nasopharyngeal carcinoma , magnetic resonance imaging , asymptomatic , retrospective cohort study , gastroenterology , nuclear medicine , radiology , radiation therapy
BACKGROUND: The purpose of this study was to evaluate the prognostic value of magnetic resonance imaging (MRI)‐detected cranial nerve (CN) involvement in nasopharyngeal carcinoma (NPC). METHODS: Retrospective analysis was made of the magnetic resonance images and medical records of 924 consecutive patients with newly diagnosed NPC. RESULTS: Of 924 patients, 82 (8.9%) initially presented with CN palsy. CN involvement was seen on MRI in 333 (36%) patients. In T3‐4 disease, MRI‐evidenced CN involvement was associated with poor 3‐year overall survival (OS) (35.7% vs 89.2%, P = .001) and distant metastasis‐free survival (DMFS) (77.1% vs 87.8%, P = .002) rates. The survival curves of OS and DMFS for T3 disease with MRI‐detected CN involvement approximated those of T4 disease ( P = .322 and P = .809, respectively). In patients with MRI‐detected CN involvement, no significant differences were observed in 3‐year OS (78.3% vs 72.9%, P = .120), local relapse‐free survival (LRFS) (89.7% vs 84.1%, P = .154), or DMFS (79.6% vs 74.8%, P = .466) rates between those with and without intracranial or orbital CN involvement. Furthermore, in patients with clinical and/or MRI‐detected CN involvement, there were no significant differences in the 3‐year OS (74.2% vs 80.1%, P = .067), LRFS (86.7% vs 87.9%, P = .899), or DMFS (74.6% vs 84.6%, P = .094) rates between symptomatic and asymptomatic patients. CONCLUSIONS: The incidence of MRI‐detected CN involvement was higher than CN palsy. MRI‐detected CN involvement has a negative impact on the prognosis independent of lesion localization and symptoms. Cancer 2009. © 2009 American Cancer Society.