Contemporary management of the neck in nasopharyngeal carcinoma

• Published in: Head & neck Vol. 43; no. 6; pp. 1949 - 1963
• Main Authors: Ng, Wai Tong, Tsang, Raymond K. Y., Beitler, Jonathan J., Bree, Remco, Coca‐Pelaz, Andrés, Eisbruch, Avraham, Guntinas‐Lichius, Orlando, Lee, Anne W. M., Mäkitie, Antti A., Mendenhall, William M., Nuyts, Sandra, Rinaldo, Alessandra, Robbins, K. Thomas, Rodrigo, Juan P., Silver, Carl E., Simo, Ricard, Smee, Robert, Strojan, Primož, Takes, Robert P., Ferlito, Alfio
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.06.2021; Wiley Subscription Services, Inc
• Subjects: Head and neck; Medicin och hälsovetenskap; Metastases; Metastasis; Nasopharyngeal carcinoma; nodal metastasis; prognosis; Radiation therapy; radiotherapy; staging; Surgery; Throat cancer; radiotherapy; nasopharyngeal carcinoma; nodal metastasis; prognosis; staging; surgery
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.26685

Up to 85% of the patients with nasopharyngeal carcinoma present with regional nodal metastasis. Although excellent nodal control is achieved with radiotherapy, a thorough understanding of the current TNM staging criteria and pattern of nodal spread is essential to optimize target delineation and minimize unnecessary irradiation to adjacent normal tissue. Selective nodal irradiation with sparing of the lower neck and submandibular region according to individual nodal risk is now emerging as the preferred treatment option. There has also been continual refinement in staging classification by incorporating relevant adverse nodal features. As for the uncommon occurrence of recurrent nodal metastasis after radiotherapy, surgery remains the standard of care.