{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:54:19Z","timestamp":1790927659343,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The objective of this study was to evaluate the prognostic value of cranial nerve invasion (CNI) in T4\u2010stage nasopharyngeal carcinoma (NPC) patients with nonmetastatic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 299 T4\u2010stage NPC patients with nonmetastatic disease in the Cancer Hospital of Shantou University Medical College. The primary outcome was the overall survival (OS), and the secondary outcome was locoregional relapse\u2010free survival (LRRFS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CNI was observed in 159 (53.2%) NPC patients with T4\u2010stage disease. The mean follow\u2010up period was 136 months (range, 3\u2013168 months). Multivariate analyses confirmed that age, pericavernous extension, lower cervical lymph nodes metastasis, CN II and CN X invasion were significant for OS. Multivariate analyses confirmed that prevertebral muscle invasion (PMI) was significant for LRRFS, whereas CNI was not significant for LRRFS. In T4\u2010stage NPC patients, significant differences were observed between the none and CNI groups in terms of the 5\u2010 and 10\u2010year OS rates (70.7%, 61.9% vs. 61.0%, 51.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), respectively. No significant difference was observed between the none and CNI groups in terms of the 5\u2010 and 10\u2010year LRRFS rates (87.4%, 78.1% vs. 88.1%, 79.8%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.71), respectively. In terms of OS, there were significant differences between the none and CN II, CN IX, CN X invasion, multiple CNI, unilateral CNI, and PMI groups, respectively (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Significant differences were observed between the none and CN VII invasion and PMI groups in terms of LRRFS (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CNI significantly affected T4\u2010stage NPC patients' survival, although it had no discernible impact on local recurrence. This study elucidates the prognostic significance of CNI among patients with T4\u2011stage NPC, thereby enabling clinicians to precisely evaluate prognosis and implement optimal therapeutic interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72908","type":"journal-article","created":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T06:20:45Z","timestamp":1785046845000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Value of Cranial Nerve Invasion in T4\u2010Stage Nasopharyngeal Carcinoma: A Retrospective Cohort Study With a Median Follow\u2010Up of 136 Months"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8432-7067","authenticated-orcid":false,"given":"Cuidai","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College Shantou University  Shantou 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