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https://doi.org/10.1016/S0360-3016(03)01618-3
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dc.title | Tailoring distant metastatic imaging for patients with clinically localized undifferentiated nasopharyngeal carcinoma | |
dc.contributor.author | Kumar, M.B. | |
dc.contributor.author | Lu, J.J. | |
dc.contributor.author | Shakespeare, T.P. | |
dc.contributor.author | Loh, K.S. | |
dc.contributor.author | Tan, K.S.L. | |
dc.contributor.author | Chong, L.M.J. | |
dc.contributor.author | Soo, R. | |
dc.contributor.author | Goh, B.C. | |
dc.date.accessioned | 2012-04-02T07:54:18Z | |
dc.date.available | 2012-04-02T07:54:18Z | |
dc.date.issued | 2004 | |
dc.identifier.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. https://doi.org/10.1016/S0360-3016(03)01618-3 | |
dc.identifier.issn | 03603016 | |
dc.identifier.uri | http://scholarbank.nus.edu.sg/handle/10635/32233 | |
dc.description.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. | |
dc.description.uri | http://libproxy1.nus.edu.sg/login?url=http://dx.doi.org/10.1016/S0360-3016(03)01618-3 | |
dc.source | Scopus | |
dc.subject | Metastases | |
dc.subject | Nasopharyngeal cancer | |
dc.subject | Staging evaluation | |
dc.type | Article | |
dc.contributor.department | PHARMACOLOGY | |
dc.contributor.department | OTOLARYNGOLOGY | |
dc.description.doi | 10.1016/S0360-3016(03)01618-3 | |
dc.description.sourcetitle | International Journal of Radiation Oncology Biology Physics | |
dc.description.volume | 58 | |
dc.description.issue | 3 | |
dc.description.page | 688-693 | |
dc.description.coden | IOBPD | |
dc.identifier.isiut | 000188934600005 | |
Appears in Collections: | Staff Publications |
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