Abstract
Although it is rare in other parts of world, nasopharyngeal carcinoma (NPC) is endemic in certain regions, especially in Southeast Asia. The incidence is 30-80 of 100,000 people per year in Southern China (Muir et al. 1987). Nasopharyngeal carcinoma has a higher incidence of cervical lymph node metastasis compared with other head and neck cancers. There is a well-developed network of lymphatics in the nasopharynx (Sham et al. 1990). The retropharyngeal lymph node (RLN) is regarded as the most common lymph node involved in NPC (King et al. 2000a). Retropharyngeal lymph nodes (RLNs) are divided into medial and lateral groups (Rouviere, 1938). The lateral nodes lie lateral to the pharyngeal constrictors and medial to the internal carotid artery. The medial group lies along or near the midline, directly posterior to the upper pharynx. RLNs are not amenable to evaluation using manual palpation. Consequently, the diagnosis of enlarged RLNs in patients with NPC is made on the basis of imaging examinations, such as x-ray computed tomography (CT), positron emission tomography (PET), and magnetic resonance imaging (MRI).
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Al-Sarraf M, LeBlanc M, Giri PG, Fu KK, Cooper J, Vuong T, Forastiere AA, Adams G, Sakr WA, Schuller DE, Ensley JF (1998) Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized intergroup study 0099. J Clin Oncol 16:1310-1317
Chong VF, Fan YF, Khoo JB (1995) Retropharyngeal lymphadenopathy in nasopharyngeal carcinoma. Eur J Radiol 21:100-105
Chua DT, Sham JS, Au GK, Choy D (2002) Concomitant chemoirradiation for stage III-IV nasopharyngeal carcinoma in Chinese patients: results of a matched cohort analysis. Int J Radiat Oncol Biol Phys 53:334-343
Chua DT, Sham JS, Kwong DL, Au GK, Choy DT (1997) Retropharyngeal lymphadenopathy in patients with nasopharyngeal carcinoma: a computed tomography-based study. Cancer 79:869-877
Cox DR (1972) Regressionmodels and life tables. J R Stat Soc Ser B 34:187-220
Curtin HD, Ishwaran H, Mancuso AA, Dalley RW, Caudry DJ, McNeil BJ (1998) Comparison of CT and MR imaging in staging of neck metastases. Radiology 207:123-130
Don DM, Anzai Y, Lufkin RB, Fu Y, Calcaterra TC (1995) Evaluation of cervical lymph node metastases in squamous cell carcinoma of the head and neck. Laryngoscope 105:669-674
Fleming ID, Cooper JS, Henson DE, Hutter RVP, Kennedy BJ, Murphy GP (1997) American Joint Committee on cancer: AJCC Cancer Staging Manual, 5th edn. Lippincott-Raven, Philadelphia
Greene FL, Page DL, Fleming ID, Fritz A, Balch CM, Haller DG, Morrow M (2002) AJCC cancer staging handbook from the AJCC cancer staging manual, 6th edn. Springer, NewYork
Groome PA, Schulze K, Boysen M, Hall SF, Mackillop WJ (2001) A comparison of published head and neck stage groupings in carcinomas of the oral cavity. Head Neck 23:613-624
Ho JHC (1978) Stage classification of nasopharyngeal carcinoma: a review. In: De-The G, EtoY (eds) Nasopharyngeal carcinoma: etiology and control. IARC Scientific publications no. 20. International Agency for Research on Cancer, Lyon, pp 99-113
Ichimura K (1993) Can Rouviere’s lymph nodes in non-malignant subjects be identified with MRI? Auris Nasus Larynx 20:117-123
Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457-481
King AD, Ahuja AT, Leung SF, Lam WW, Teo P, Chan YL, Metreweli C (2000a) Neck node metastases from nasopharyngeal carcinoma: MR imaging of patterns of disease. Head Neck 22:275-281
King AD, Teo P, Lam WW, Leung SF, Metreweli C (2000b) Paranasopharyngeal space involvement in nasopharyngeal cancer: detection by CT and MRI. Clin Oncol 12:397-402
Lam WW, Chan YL, Leung SF, Metreweli C (1997) Retropharyngeal lymphadenopathy in nasopharyngeal carcinoma. Head Neck 19:176-181
Lee AW, Au JS, Teo PM, Leung TW, Chua DT, Sze WM, Zee BC, Law SC, Leung SF, Tung SY, Kwong DL, Lau WH (2004) Staging of nasopharyngeal carcinoma: suggestions for improving the current UICC/AJCC Staging System. Clin Oncol 16:269-276
Lee AW, Lau WH, Tung SY, Chua DT, Chappell R, Xu L, Siu L, Sze WM, Leung TW, Sham JS, Ngan RK, Law SC, Yau TK, Au JS, O’Sullivan B, Pang ES, O SK, Au GK, Lau JT (2005) Hong Kong Nasopharyngeal Cancer Study Group. Preliminary results of a randomized study on therapeutic gain by concurrent chemotherapy for regionally-advanced nasopharyngeal carcinoma: NPC-9901 trial by the Hong Kong Nasopharyngeal Cancer Study Group. J Clin Oncol 23:6966-6975
Mancuso AA, Harnsberger HR, Muraki AS, Stevens MH (1983) Computed tomography of cervical and retropharyngeal lymphnodes: normal anatomy, variants of normal, and applications in staging head and neck cancer. Part II. Pathology. Radiology 148:715-723
Marks JE, Bedwinek JM, Lee F, Purdy JA, Perez CA (1982) Dose-response analysis for nasopharyngeal carcinoma: An historical perspective. Cancer 50:1042-1050
McLaughlin MP, Mendenhall WM, Mancuso AA, Parsons JT, McCarty PJ, Cassisi NJ, Stringer SP, Tart RP, Mukherji SK, Million RR (1995) Retropharyngeal adenopathy as a predictor of outcome in squamous cell carcinoma of the head and neck. Head Neck 17:190-198
Muir CS, Waterhouse J, Mack T (1987) Cancer incidence in five continents, Vol. 5. IARC Scientific Publication No. 88, IARC, Lyon.
Mukherji S, Armao D, Joshi V (2001) Cervical nodal metastases in squamous cell carcinoma of the head and neck: What to expect. Head Neck 23:995-1005
Neel HB, Taylor WF, Pearson GR (1985) Prognostic determinants and a new view of staging for patients with nasopharyngeal carcinoma. Ann Otol Rhinol Laryngol 94:529-537
Ng SH, Chang JT, Chan SC, Ko SF, Wang HM, Liao CT, Chang YC, Yen TC (2004) Nodal metastases of nasopharyngeal carcinoma: patterns of disease on MRI and FDGPET. Eur J Nucl Med Mol Imaging 31:1073-1080
Ng SH, Chang TC, Ko SF, Yen PS, Wan YL, Tang LM, Tsai MH (1997) Nasopharyngeal carcinoma: MRI and CT assessment. Neuroradiology 39:741-746
Ogura I, Kaneda T, Kato M, Mori S, Motohashi J, Lee K (2004) MR study of lateral retropharyngeal lymph nodes at different ages. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:355-358
Olmi P, Fallai C, Colagrande S, Giannardi G (1995) Staging and follow-up of nasopharyngeal carcinoma: magnetic resonance imaging versus computerized tomography. Int J Radiat Oncol Biol Phys 32:795-800
Rouviere H (1938) Antomy of human lymphatic system. Edward Brothers, Ann Arbor, MI
Rufener JB, Cohen JI (2003) Metachronous spread of parathyroid carcinoma to a retropharyngeal lymph node. Head Neck 25:968-971
Sakata K, Hareyama M, Tamakawa M, Oouchi A, Sido M, Nagakura H, Akiba H, Koito K, Himi T, Asakura K (1999) Prognostic factors of nasopharynx tumors investigated by MR imaging and the value of MR imaging in the newly published TNM staging. Int J Radiat Oncol Biol Phys 43:273-278
Sham JST, Choy D (1991) Prognostic value of parapharyngealcarcimoma: onlocalcontrolandshort-termsurvival. Head Neck 13:298-310
Sham JST, Choy D, Wei WI (1990) Nasopharyngeal carcinoma: orderly neck node spread. Int J Radiat Oncol Biol Phys 19:929-933
Sobin LH, Wittekind CH (1997) International union against cancer (UICC): TNM classification of malignant tumours, 5th edn. Wiley-Liss, NewYork
Som PM (1992) Detection of metastasis in cervical lymph nodes: CTand MR criteria and differential diagnosis. Am J Roentgenol 158:961-969
Som PM, Curtin HD, Mancuso AA (2000) Imaging-based nodal classification for evaluation of neck metastatic adenopathy. Am J Roentgenol 174:837-844
Tsao SY (1991) Technical details for radiotherapy delivery. In: van Hasselt CA, Gibb AG (eds) Nasopharyngeal carcinoma. The Chinese University Press, Hong Kong, pp 207-208
Van den Brekel MW, Stel HV, Castelijns JA, Nauta JJ, van der Waal I, Valk J, Meyer CJ, Snow GB (1990) Cervical lymph node metastasis: assessment of radiologic criteria. Radiology 177:379-384
Van Hasselt CA (1999) Nasopharyngeal carcinoma, 2nd edn. The Chinese University Press, Hong Kong, pp 127-160
Vikram B, Mishra UB, Strong EW, Manolatos S (1985) Patterns of failure in carcinoma of the nasopharynx: I. Failure at the primary site. Int J Radiat Oncol Biol Phys 11:1455-1459
Wee J, Tan EH, Tai BC, Wong HB, Leong SS, Tan T, Chua ET, Yang E, Lee KM, Fong KW, Tan HS, Lee KS, Loong S, Sethi V, Chua EJ, Machin D (2005) Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage III and IV nasopharyngeal cancer of the endemic variety. J Clin Oncol 23:6730-6738
Xiao GL, Gao L, Xu GZ (2002) Prognostic influence of parapharyngeal space involvement in nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 52:957-963
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer Science+Business Media B.V.
About this chapter
Cite this chapter
Li, L., Liu, LZ. (2010). Nasopharyngeal Carcinoma (Retropharyngeal Lymph Node Metastasis): Spread Pattern, Prognosis, and Staging. In: Hayat, M. (eds) Methods of Cancer Diagnosis, Therapy, and Prognosis. Methods of Cancer Diagnosis, Therapy and Prognosis, vol 7. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-3186-0_21
Download citation
DOI: https://doi.org/10.1007/978-90-481-3186-0_21
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-90-481-3185-3
Online ISBN: 978-90-481-3186-0
eBook Packages: MedicineMedicine (R0)