Please use this identifier to cite or link to this item:
|Title:||Tailoring distant metastatic imaging for patients with clinically localized undifferentiated nasopharyngeal carcinoma|
|Citation:||Kumar, M.B., Lu, J.J., Shakespeare, T.P., Loh, K.S., Tan, K.S.L., Chong, L.M.J., Soo, R., Goh, B.C. (2004). Tailoring distant metastatic imaging for patients with clinically localized undifferentiated nasopharyngeal carcinoma. International Journal of Radiation Oncology Biology Physics 58 (3) : 688-693. ScholarBank@NUS Repository.|
|Abstract:||Purpose: The 2000 practice guidelines of the National Comprehensive Cancer Network recommend World Health Organization Type 2-3 nasopharyngeal carcinoma (NPC) be staged for distant disease using chest X-ray and bone scan. Our aim was to evaluate these modalities plus liver ultrasonography for American Joint Committee on Cancer/International Union Against Cancer 1997 clinical Stage I-IVB NPC. Methods and Materials: Between February 1999 and May 2002, all patients with clinical (examination plus CT/MRI of head and neck) Stage I-IVB undifferentiated NPC were prospectively evaluated for distant disease with chest X-ray, liver ultrasonography, and bone scan. Suspicious lesions underwent confirmatory investigation, and patients were reevaluated at 4 months. Results: In the 139 patients evaluated, the positive yield was 3.6% and prevalence was 5.8% (0.7% lung, 2.2% skeletal, and 2.9% liver metastases). The prevalence increased by N stage (p = 0.004) and overall stage (p = 0.05). Compared with N3 disease (odds ratio 1.0), the odds of metastases for N0, N1, and N2 disease was 0, 0.12, and 0.33, respectively. The positive yield was 0%, 1.8%, 4.8%, and 14.3% for N0, N1, N2, and N3 disease, respectively. Conclusion: This is the first study to evaluate the use of distant staging investigations for American Joint Committee on Cancer/International Union Against Cancer 1997 staged NPC. We recommend alterations to the 2000 National Comprehensive Cancer Network guidelines as follows: high-risk (N3) disease should be fully staged with chest X-ray, bone scan, and liver ultrasonography; intermediate risk (N1 and N2) disease may be staged using all three modalities on an institutional basis. No evidence supports distant imaging for low-risk (N0 or Stage I) disease. © 2004 Elsevier Inc.|
|Source Title:||International Journal of Radiation Oncology Biology Physics|
|Appears in Collections:||Staff Publications|
Show full item record
Files in This Item:
There are no files associated with this item.
checked on Feb 28, 2018
WEB OF SCIENCETM
checked on Apr 30, 2018
checked on May 19, 2018
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.