{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:07:25Z","timestamp":1787800045469,"version":"build-2784847793"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,9,6]],"date-time":"2017-09-06T00:00:00Z","timestamp":1504656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["U1405221"],"award-info":[{"award-number":["U1405221"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2017,10]]},"abstract":"Abstract<\/jats:title>Parotid area lymph node (PLN<\/jats:styled-content>) metastasis in nasopharyngeal carcinoma (NPC<\/jats:styled-content>) is rare, and its prognosis remains largely unknown. Our study aimed to investigate the prognostic value and staging categories of PLN<\/jats:styled-content> metastasis in patients with NPC<\/jats:styled-content> and treated with intensity\u2010modulated radiation therapy (IMRT<\/jats:styled-content>), to provide a reference for clinical treatment for NPC<\/jats:styled-content> with PLN<\/jats:styled-content> metastasis. Records for 1616 untreated NPC<\/jats:styled-content> patients without distant metastasis was retrospectively reviewed. All patients underwent magnetic resonance imaging (MRI<\/jats:styled-content>) examination prior to treatment and then received IMRT<\/jats:styled-content> as their primary treatment. Forty\u2010five NPC<\/jats:styled-content> patients (2.8%) showed initial PLN<\/jats:styled-content> metastasis on follow\u2010up MRI<\/jats:styled-content>. PLN<\/jats:styled-content> metastasis was significantly associated with the N classification and clinical stage. Univariate analysis showed that PLN<\/jats:styled-content> metastasis had an unfavorable influence on overall survival (OS<\/jats:styled-content>), progression\u2010free survival (PFS<\/jats:styled-content>), distant metastasis\u2010free survival (DMFS<\/jats:styled-content>), and regional relapse\u2010free survival (RRFS<\/jats:styled-content>) in NPC<\/jats:styled-content> patients. Using propensity score matching (PSM<\/jats:styled-content>) to calibrate selection bias and confounding bias, it was observed that PLN<\/jats:styled-content> metastasis remained an adverse prognostic factor for OS<\/jats:styled-content>, PFS<\/jats:styled-content>, DMFS<\/jats:styled-content>, and RRFS<\/jats:styled-content>. Furthermore, the 5\u2010year DMFS<\/jats:styled-content> and RRFS<\/jats:styled-content> curves for PLN<\/jats:styled-content> metastasis were significantly separated from that for N2 disease but crossed that for N3 disease. Therefore, PLN<\/jats:styled-content> metastasis was found to be an adverse prognostic factor for NPC<\/jats:styled-content> and to be associated with the same DMFS<\/jats:styled-content> as N3 disease. Therefore, more aggressive therapeutic strategies consistent with those for N3 disease are recommended for NPC<\/jats:styled-content> with PLN<\/jats:styled-content> metastasis to reduce distant metastasis.<\/jats:p>","DOI":"10.1002\/cam4.1154","type":"journal-article","created":{"date-parts":[[2017,9,7]],"date-time":"2017-09-07T02:02:41Z","timestamp":1504749761000},"page":"2213-2221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Prognostic effect of parotid area lymph node metastases after preliminary diagnosis of nasopharyngeal carcinoma: a propensity score matching study"],"prefix":"10.1002","volume":"6","author":[{"given":"Yuanji","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Fujian Cancer Hospital Fujian Medical University Cancer Hospital Fuzhou Fujian 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