MRI of nasopharyngeal carcinoma: parapharyngeal subspace involvement has prognostic value and influences T-staging in the IMRT era
Objectives To identify the prognosis of parapharyngeal space involvement (PPSI) based on the number of subspaces involved (pre-styloid space, carotid space (CS), areas outside the CS) and explore its significance for current T-staging in patients with nasopharyngeal carcinoma (NPC). Methods PPSI was...
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| Veröffentlicht in: | European radiology 2022, Vol.32 (1), p.262-271 |
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| creator | Huang, Wenjie Quan, Tingting Zhao, Qin Li, Shuqi Cai, Yi Zhou, Jian Luo, Chao Ruan, Guangying Cui, Chunyan Liang, Shaobo Li, Haojiang Liu, Lizhi |
| description | Objectives
To identify the prognosis of parapharyngeal space involvement (PPSI) based on the number of subspaces involved (pre-styloid space, carotid space (CS), areas outside the CS) and explore its significance for current T-staging in patients with nasopharyngeal carcinoma (NPC).
Methods
PPSI was retrospectively identified in 1224 patients with non-disseminated NPC at two centers on MRI and separated into four invasion patterns: pattern A (only post-styloid space), pattern B (post-styloid space, CS extension), pattern C (post-styloid space, pre-styloid space extension), and pattern D (all spaces). The Kaplan–Meier analysis and multivariate Cox regression models were used.
Results
PPSI was diagnosed in 63.4% of cases, with patterns A, B, C, and D in 14.3%, 3.8%, 25.3%, and 18.6% of cases, respectively. No prognostic heterogeneity was observed between pattern B and pattern C (
p
> 0.05). Thus, the degree of PPSI was based on the number of subspaces involved: grade 0 (none), grade 1 (one), grade 2 (two), and grade 3 (three), which could independently predict overall survival (OS) (
p
< 0.001). T3 patients with grade 0/1 PPSI (slight-T3) had a better prognosis than those with grade 2/3 PPSI (severe-T3) in terms of OS, locoregional-free survival (LRFS), and progression-free survival (PFS) (all
p
< 0.001), whose hazard ratios were higher and lower than those with T1 and T2, respectively. Combining the T2 and slight-T3 groups as the proposed T2 provided significant differences in OS, LRFS, and PFS between T2 and T3 (all
p
< 0.05).
Conclusions
The risk of death increased with the number of parapharyngeal subspaces involved. The degree of PPSI is recommended to optimize T3 heterogeneity.
Key Points
•
Parapharyngeal space involvement was proposed to differentiate patient risk groups based on the number of involved subspaces: grade 0 (none), grade 1 (one), grade 2 (two), or grade 3 (three).
•
The degree of parapharyngeal space involvement was an independent negative prognosticator for OS.
•
The degree of parapharyngeal space involvement may influence T-staging in patients with nasopharyngeal carcinoma. |
| doi_str_mv | 10.1007/s00330-021-08113-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2557228425</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2608265378</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-17fbf7088c1b0ae0ad1e57ba21d66a805f961a73909f05f84e6f69146b4daf93</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi1ERZfCH-CALHHhYjq2E9vhhio-VmpVqdq7NXHs3VSJE-xkJa78cgxbPsShJ489z7yemZeQVxzecQB9mQGkBAaCMzCcSyafkA2vpGAcTPWUbKCRhummqc7J85zvAaDhlX5GzmWBdK3Vhny_udvSKdCIeZoPmL7FvceBOkyuj9OI7-mMCf_J5LXNMzpP-3ichqMffVzoATOd07SPU156R484rJ5i7AoUShidz3TH8oL7Pu7LI10Onm5v7nbUJ3xBzgIO2b98OC_I7tPH3dUXdn37eXv14Zo5qeuFcR3aoMEYx1tAD9hxX-sWBe-UQgN1aBRHLRtoQrmYyqugyryqrToMjbwgb0-ypdGvq8-LHfvs_DBg9NOarahrLYSpRF3QN_-h99OaYmnOCgVGqFpqUyhxolyack4-2Dn1Y1mU5WB_GmRPBtlikP1lkJWl6PWD9NqOvvtT8tuRAsgTkEuqrDz9_fsR2R-mGZxn</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2608265378</pqid></control><display><type>article</type><title>MRI of nasopharyngeal carcinoma: parapharyngeal subspace involvement has prognostic value and influences T-staging in the IMRT era</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Huang, Wenjie ; Quan, Tingting ; Zhao, Qin ; Li, Shuqi ; Cai, Yi ; Zhou, Jian ; Luo, Chao ; Ruan, Guangying ; Cui, Chunyan ; Liang, Shaobo ; Li, Haojiang ; Liu, Lizhi</creator><creatorcontrib>Huang, Wenjie ; Quan, Tingting ; Zhao, Qin ; Li, Shuqi ; Cai, Yi ; Zhou, Jian ; Luo, Chao ; Ruan, Guangying ; Cui, Chunyan ; Liang, Shaobo ; Li, Haojiang ; Liu, Lizhi</creatorcontrib><description>Objectives
To identify the prognosis of parapharyngeal space involvement (PPSI) based on the number of subspaces involved (pre-styloid space, carotid space (CS), areas outside the CS) and explore its significance for current T-staging in patients with nasopharyngeal carcinoma (NPC).
Methods
PPSI was retrospectively identified in 1224 patients with non-disseminated NPC at two centers on MRI and separated into four invasion patterns: pattern A (only post-styloid space), pattern B (post-styloid space, CS extension), pattern C (post-styloid space, pre-styloid space extension), and pattern D (all spaces). The Kaplan–Meier analysis and multivariate Cox regression models were used.
Results
PPSI was diagnosed in 63.4% of cases, with patterns A, B, C, and D in 14.3%, 3.8%, 25.3%, and 18.6% of cases, respectively. No prognostic heterogeneity was observed between pattern B and pattern C (
p
> 0.05). Thus, the degree of PPSI was based on the number of subspaces involved: grade 0 (none), grade 1 (one), grade 2 (two), and grade 3 (three), which could independently predict overall survival (OS) (
p
< 0.001). T3 patients with grade 0/1 PPSI (slight-T3) had a better prognosis than those with grade 2/3 PPSI (severe-T3) in terms of OS, locoregional-free survival (LRFS), and progression-free survival (PFS) (all
p
< 0.001), whose hazard ratios were higher and lower than those with T1 and T2, respectively. Combining the T2 and slight-T3 groups as the proposed T2 provided significant differences in OS, LRFS, and PFS between T2 and T3 (all
p
< 0.05).
Conclusions
The risk of death increased with the number of parapharyngeal subspaces involved. The degree of PPSI is recommended to optimize T3 heterogeneity.
Key Points
•
Parapharyngeal space involvement was proposed to differentiate patient risk groups based on the number of involved subspaces: grade 0 (none), grade 1 (one), grade 2 (two), or grade 3 (three).
•
The degree of parapharyngeal space involvement was an independent negative prognosticator for OS.
•
The degree of parapharyngeal space involvement may influence T-staging in patients with nasopharyngeal carcinoma.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-021-08113-3</identifier><identifier>PMID: 34327576</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cancer ; Diagnostic Radiology ; Head and Neck ; Heterogeneity ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Magnetic Resonance Imaging ; Medical prognosis ; Medicine ; Medicine & Public Health ; Nasopharyngeal carcinoma ; Nasopharyngeal Carcinoma - diagnostic imaging ; Nasopharyngeal Carcinoma - radiotherapy ; Nasopharyngeal Neoplasms - diagnostic imaging ; Nasopharyngeal Neoplasms - pathology ; Nasopharyngeal Neoplasms - radiotherapy ; Neoplasm Staging ; Neuroradiology ; Prognosis ; Radiology ; Radiotherapy, Intensity-Modulated ; Regression analysis ; Regression models ; Retrospective Studies ; Risk groups ; Subspaces ; Survival ; Throat cancer ; Ultrasound</subject><ispartof>European radiology, 2022, Vol.32 (1), p.262-271</ispartof><rights>European Society of Radiology 2021</rights><rights>2021. European Society of Radiology.</rights><rights>European Society of Radiology 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-17fbf7088c1b0ae0ad1e57ba21d66a805f961a73909f05f84e6f69146b4daf93</citedby><cites>FETCH-LOGICAL-c375t-17fbf7088c1b0ae0ad1e57ba21d66a805f961a73909f05f84e6f69146b4daf93</cites><orcidid>0000-0002-3977-0518</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-021-08113-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-021-08113-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34327576$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, Wenjie</creatorcontrib><creatorcontrib>Quan, Tingting</creatorcontrib><creatorcontrib>Zhao, Qin</creatorcontrib><creatorcontrib>Li, Shuqi</creatorcontrib><creatorcontrib>Cai, Yi</creatorcontrib><creatorcontrib>Zhou, Jian</creatorcontrib><creatorcontrib>Luo, Chao</creatorcontrib><creatorcontrib>Ruan, Guangying</creatorcontrib><creatorcontrib>Cui, Chunyan</creatorcontrib><creatorcontrib>Liang, Shaobo</creatorcontrib><creatorcontrib>Li, Haojiang</creatorcontrib><creatorcontrib>Liu, Lizhi</creatorcontrib><title>MRI of nasopharyngeal carcinoma: parapharyngeal subspace involvement has prognostic value and influences T-staging in the IMRT era</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
To identify the prognosis of parapharyngeal space involvement (PPSI) based on the number of subspaces involved (pre-styloid space, carotid space (CS), areas outside the CS) and explore its significance for current T-staging in patients with nasopharyngeal carcinoma (NPC).
Methods
PPSI was retrospectively identified in 1224 patients with non-disseminated NPC at two centers on MRI and separated into four invasion patterns: pattern A (only post-styloid space), pattern B (post-styloid space, CS extension), pattern C (post-styloid space, pre-styloid space extension), and pattern D (all spaces). The Kaplan–Meier analysis and multivariate Cox regression models were used.
Results
PPSI was diagnosed in 63.4% of cases, with patterns A, B, C, and D in 14.3%, 3.8%, 25.3%, and 18.6% of cases, respectively. No prognostic heterogeneity was observed between pattern B and pattern C (
p
> 0.05). Thus, the degree of PPSI was based on the number of subspaces involved: grade 0 (none), grade 1 (one), grade 2 (two), and grade 3 (three), which could independently predict overall survival (OS) (
p
< 0.001). T3 patients with grade 0/1 PPSI (slight-T3) had a better prognosis than those with grade 2/3 PPSI (severe-T3) in terms of OS, locoregional-free survival (LRFS), and progression-free survival (PFS) (all
p
< 0.001), whose hazard ratios were higher and lower than those with T1 and T2, respectively. Combining the T2 and slight-T3 groups as the proposed T2 provided significant differences in OS, LRFS, and PFS between T2 and T3 (all
p
< 0.05).
Conclusions
The risk of death increased with the number of parapharyngeal subspaces involved. The degree of PPSI is recommended to optimize T3 heterogeneity.
Key Points
•
Parapharyngeal space involvement was proposed to differentiate patient risk groups based on the number of involved subspaces: grade 0 (none), grade 1 (one), grade 2 (two), or grade 3 (three).
•
The degree of parapharyngeal space involvement was an independent negative prognosticator for OS.
•
The degree of parapharyngeal space involvement may influence T-staging in patients with nasopharyngeal carcinoma.</description><subject>Cancer</subject><subject>Diagnostic Radiology</subject><subject>Head and Neck</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Magnetic Resonance Imaging</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nasopharyngeal carcinoma</subject><subject>Nasopharyngeal Carcinoma - diagnostic imaging</subject><subject>Nasopharyngeal Carcinoma - radiotherapy</subject><subject>Nasopharyngeal Neoplasms - diagnostic imaging</subject><subject>Nasopharyngeal Neoplasms - pathology</subject><subject>Nasopharyngeal Neoplasms - radiotherapy</subject><subject>Neoplasm Staging</subject><subject>Neuroradiology</subject><subject>Prognosis</subject><subject>Radiology</subject><subject>Radiotherapy, Intensity-Modulated</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Retrospective Studies</subject><subject>Risk groups</subject><subject>Subspaces</subject><subject>Survival</subject><subject>Throat cancer</subject><subject>Ultrasound</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kU1v1DAQhi1ERZfCH-CALHHhYjq2E9vhhio-VmpVqdq7NXHs3VSJE-xkJa78cgxbPsShJ489z7yemZeQVxzecQB9mQGkBAaCMzCcSyafkA2vpGAcTPWUbKCRhummqc7J85zvAaDhlX5GzmWBdK3Vhny_udvSKdCIeZoPmL7FvceBOkyuj9OI7-mMCf_J5LXNMzpP-3ichqMffVzoATOd07SPU156R484rJ5i7AoUShidz3TH8oL7Pu7LI10Onm5v7nbUJ3xBzgIO2b98OC_I7tPH3dUXdn37eXv14Zo5qeuFcR3aoMEYx1tAD9hxX-sWBe-UQgN1aBRHLRtoQrmYyqugyryqrToMjbwgb0-ypdGvq8-LHfvs_DBg9NOarahrLYSpRF3QN_-h99OaYmnOCgVGqFpqUyhxolyack4-2Dn1Y1mU5WB_GmRPBtlikP1lkJWl6PWD9NqOvvtT8tuRAsgTkEuqrDz9_fsR2R-mGZxn</recordid><startdate>2022</startdate><enddate>2022</enddate><creator>Huang, Wenjie</creator><creator>Quan, Tingting</creator><creator>Zhao, Qin</creator><creator>Li, Shuqi</creator><creator>Cai, Yi</creator><creator>Zhou, Jian</creator><creator>Luo, Chao</creator><creator>Ruan, Guangying</creator><creator>Cui, Chunyan</creator><creator>Liang, Shaobo</creator><creator>Li, Haojiang</creator><creator>Liu, Lizhi</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3977-0518</orcidid></search><sort><creationdate>2022</creationdate><title>MRI of nasopharyngeal carcinoma: parapharyngeal subspace involvement has prognostic value and influences T-staging in the IMRT era</title><author>Huang, Wenjie ; Quan, Tingting ; Zhao, Qin ; Li, Shuqi ; Cai, Yi ; Zhou, Jian ; Luo, Chao ; Ruan, Guangying ; Cui, Chunyan ; Liang, Shaobo ; Li, Haojiang ; Liu, Lizhi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-17fbf7088c1b0ae0ad1e57ba21d66a805f961a73909f05f84e6f69146b4daf93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cancer</topic><topic>Diagnostic Radiology</topic><topic>Head and Neck</topic><topic>Heterogeneity</topic><topic>Humans</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Magnetic Resonance Imaging</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nasopharyngeal carcinoma</topic><topic>Nasopharyngeal Carcinoma - diagnostic imaging</topic><topic>Nasopharyngeal Carcinoma - radiotherapy</topic><topic>Nasopharyngeal Neoplasms - diagnostic imaging</topic><topic>Nasopharyngeal Neoplasms - pathology</topic><topic>Nasopharyngeal Neoplasms - radiotherapy</topic><topic>Neoplasm Staging</topic><topic>Neuroradiology</topic><topic>Prognosis</topic><topic>Radiology</topic><topic>Radiotherapy, Intensity-Modulated</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Retrospective Studies</topic><topic>Risk groups</topic><topic>Subspaces</topic><topic>Survival</topic><topic>Throat cancer</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huang, Wenjie</creatorcontrib><creatorcontrib>Quan, Tingting</creatorcontrib><creatorcontrib>Zhao, Qin</creatorcontrib><creatorcontrib>Li, Shuqi</creatorcontrib><creatorcontrib>Cai, Yi</creatorcontrib><creatorcontrib>Zhou, Jian</creatorcontrib><creatorcontrib>Luo, Chao</creatorcontrib><creatorcontrib>Ruan, Guangying</creatorcontrib><creatorcontrib>Cui, Chunyan</creatorcontrib><creatorcontrib>Liang, Shaobo</creatorcontrib><creatorcontrib>Li, Haojiang</creatorcontrib><creatorcontrib>Liu, Lizhi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection (ProQuest)</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huang, Wenjie</au><au>Quan, Tingting</au><au>Zhao, Qin</au><au>Li, Shuqi</au><au>Cai, Yi</au><au>Zhou, Jian</au><au>Luo, Chao</au><au>Ruan, Guangying</au><au>Cui, Chunyan</au><au>Liang, Shaobo</au><au>Li, Haojiang</au><au>Liu, Lizhi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>MRI of nasopharyngeal carcinoma: parapharyngeal subspace involvement has prognostic value and influences T-staging in the IMRT era</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2022</date><risdate>2022</risdate><volume>32</volume><issue>1</issue><spage>262</spage><epage>271</epage><pages>262-271</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
To identify the prognosis of parapharyngeal space involvement (PPSI) based on the number of subspaces involved (pre-styloid space, carotid space (CS), areas outside the CS) and explore its significance for current T-staging in patients with nasopharyngeal carcinoma (NPC).
Methods
PPSI was retrospectively identified in 1224 patients with non-disseminated NPC at two centers on MRI and separated into four invasion patterns: pattern A (only post-styloid space), pattern B (post-styloid space, CS extension), pattern C (post-styloid space, pre-styloid space extension), and pattern D (all spaces). The Kaplan–Meier analysis and multivariate Cox regression models were used.
Results
PPSI was diagnosed in 63.4% of cases, with patterns A, B, C, and D in 14.3%, 3.8%, 25.3%, and 18.6% of cases, respectively. No prognostic heterogeneity was observed between pattern B and pattern C (
p
> 0.05). Thus, the degree of PPSI was based on the number of subspaces involved: grade 0 (none), grade 1 (one), grade 2 (two), and grade 3 (three), which could independently predict overall survival (OS) (
p
< 0.001). T3 patients with grade 0/1 PPSI (slight-T3) had a better prognosis than those with grade 2/3 PPSI (severe-T3) in terms of OS, locoregional-free survival (LRFS), and progression-free survival (PFS) (all
p
< 0.001), whose hazard ratios were higher and lower than those with T1 and T2, respectively. Combining the T2 and slight-T3 groups as the proposed T2 provided significant differences in OS, LRFS, and PFS between T2 and T3 (all
p
< 0.05).
Conclusions
The risk of death increased with the number of parapharyngeal subspaces involved. The degree of PPSI is recommended to optimize T3 heterogeneity.
Key Points
•
Parapharyngeal space involvement was proposed to differentiate patient risk groups based on the number of involved subspaces: grade 0 (none), grade 1 (one), grade 2 (two), or grade 3 (three).
•
The degree of parapharyngeal space involvement was an independent negative prognosticator for OS.
•
The degree of parapharyngeal space involvement may influence T-staging in patients with nasopharyngeal carcinoma.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34327576</pmid><doi>10.1007/s00330-021-08113-3</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3977-0518</orcidid></addata></record> |
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| ispartof | European radiology, 2022, Vol.32 (1), p.262-271 |
| issn | 0938-7994 1432-1084 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Cancer Diagnostic Radiology Head and Neck Heterogeneity Humans Imaging Internal Medicine Interventional Radiology Magnetic Resonance Imaging Medical prognosis Medicine Medicine & Public Health Nasopharyngeal carcinoma Nasopharyngeal Carcinoma - diagnostic imaging Nasopharyngeal Carcinoma - radiotherapy Nasopharyngeal Neoplasms - diagnostic imaging Nasopharyngeal Neoplasms - pathology Nasopharyngeal Neoplasms - radiotherapy Neoplasm Staging Neuroradiology Prognosis Radiology Radiotherapy, Intensity-Modulated Regression analysis Regression models Retrospective Studies Risk groups Subspaces Survival Throat cancer Ultrasound |
| title | MRI of nasopharyngeal carcinoma: parapharyngeal subspace involvement has prognostic value and influences T-staging in the IMRT era |
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