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已发表论文
鼻咽癌患者颈部淋巴结活检的预后意义：一项回顾性分析
Authors Sang R, Tang Z, Xu X, Qin S, Zhou J
Received 14 March 2025
Accepted for publication 30 October 2025
Published 10 November 2025 Volume 2025:17 Pages 2675—2690
DOI https://doi.org/10.2147/CMAR.S528354
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Harikrishna Nakshatri
Ru Sang,1 Zaixiang Tang,2 Xiaoting Xu,1 Songbing Qin,1 Juying Zhou1
1Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215000, People’s Republic of China; 2Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, 215123, People’s Republic of China
Correspondence: Juying Zhou, Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, No. 188, Shizi Street, Gusu District, Suzhou, Jiangsu, 215000, People’s Republic of China, Tel +86 13962142066, Email zhoujuyingsy@163.com
Background: The impact of cervical lymph node biopsy on survival, distant metastasis, and local recurrence in nasopharyngeal carcinoma (NPC) patients remains controversial. This study aims to compare the effects of cervical lymph node biopsy and nasopharyngeal biopsy on these outcomes.
Methods: This retrospective study enrolled NPC patients treated at the First Affiliated Hospital of Soochow University between January 2013 and December 2021. Kaplan-Meier method was used to evaluate the overall survival (OS), distant metastasis-free survival (DMFS), locoregional recurrence-free survival (LRFS), nodal recurrence-free survival (NRFS), and progression-free survival (PFS), with comparisons using the Log rank test. Univariate and multivariate Cox regression models were used to identify independent prognostic factors.
Results: A total of 721 NPC patients who underwent radiotherapy were retrospectively analyzed. Among them, 591 were diagnosed with nasopharyngeal biopsy, and 130 patients with cervical lymph node metastasis suspected to originate from NPC underwent confirmatory nasopharyngeal biopsy. In cervical lymph node biopsy, 36 had excisional biopsies, 85 had fine needle aspirations, and 9 cases were unspecified. Survival was not significantly different between patients with nasopharyngeal biopsy and cervical lymph node biopsy (5-year OS: 81.1% vs 85.0%; DMFS: 75.2% vs 80.6%; LRFS: 79.5% vs 78.7%; NRFS: 80.4% vs 80.4%; PFS: 74.3% vs 74.3%; all p> 0.05). Results were similar for the propensity-matched cohort of 260 patients.Additionally, survival was not significantly different between the fine needle aspiration and excision biopsy groups (5-year OS: 85.1% vs 83.5%; DMFS: 79.7% vs 80.3%; LRFS: 85.2% vs 74.8%; NRFS: 85.1% vs 77.7%; PFS: 79.8% vs 71.7%; all p> 0.05). Targeted therapy and > 3 cycles of chemotherapy were prognostic factors in NPC patients (p< 0.05).
Conclusion: Cervical lymph node biopsy did not increase the risk of locoregional recurrence, distant metastasis, or death in NPC patients.
Keywords: nasopharyngeal carcinoma, intensity-modulated radiotherapy, cervical lymph node biopsy, nasopharyngeal biopsy, overall survival, volumetric-modulated arc therapy
1Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215000, People’s Republic of China; 2Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, 215123, People’s Republic of China
Correspondence: Juying Zhou, Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, No. 188, Shizi Street, Gusu District, Suzhou, Jiangsu, 215000, People’s Republic of China, Tel +86 13962142066, Email zhoujuyingsy@163.com
Background: The impact of cervical lymph node biopsy on survival, distant metastasis, and local recurrence in nasopharyngeal carcinoma (NPC) patients remains controversial. This study aims to compare the effects of cervical lymph node biopsy and nasopharyngeal biopsy on these outcomes.
Methods: This retrospective study enrolled NPC patients treated at the First Affiliated Hospital of Soochow University between January 2013 and December 2021. Kaplan-Meier method was used to evaluate the overall survival (OS), distant metastasis-free survival (DMFS), locoregional recurrence-free survival (LRFS), nodal recurrence-free survival (NRFS), and progression-free survival (PFS), with comparisons using the Log rank test. Univariate and multivariate Cox regression models were used to identify independent prognostic factors.
Results: A total of 721 NPC patients who underwent radiotherapy were retrospectively analyzed. Among them, 591 were diagnosed with nasopharyngeal biopsy, and 130 patients with cervical lymph node metastasis suspected to originate from NPC underwent confirmatory nasopharyngeal biopsy. In cervical lymph node biopsy, 36 had excisional biopsies, 85 had fine needle aspirations, and 9 cases were unspecified. Survival was not significantly different between patients with nasopharyngeal biopsy and cervical lymph node biopsy (5-year OS: 81.1% vs 85.0%; DMFS: 75.2% vs 80.6%; LRFS: 79.5% vs 78.7%; NRFS: 80.4% vs 80.4%; PFS: 74.3% vs 74.3%; all p> 0.05). Results were similar for the propensity-matched cohort of 260 patients.Additionally, survival was not significantly different between the fine needle aspiration and excision biopsy groups (5-year OS: 85.1% vs 83.5%; DMFS: 79.7% vs 80.3%; LRFS: 85.2% vs 74.8%; NRFS: 85.1% vs 77.7%; PFS: 79.8% vs 71.7%; all p> 0.05). Targeted therapy and > 3 cycles of chemotherapy were prognostic factors in NPC patients (p< 0.05).
Conclusion: Cervical lymph node biopsy did not increase the risk of locoregional recurrence, distant metastasis, or death in NPC patients.
Keywords: nasopharyngeal carcinoma, intensity-modulated radiotherapy, cervical lymph node biopsy, nasopharyngeal biopsy, overall survival, volumetric-modulated arc therapy