Lymph node XXXX in @entity1177 .

@entity1 @entity1177 @entity5 @entity2347 @entity957 @entity1600 @entity189 @entity3 @entity420
PURPOSE: To evaluate the incidence and prognostic significance of @entity1600 in @entity1177 . METHODS AND MATERIALS: We reviewed the records of 97 @entity1 treated for @entity1177 with radiotherapy at Stanford University and at the University of California, San Francisco between 1959 and 1996. Fifty-eight @entity1 had @entity957 ( @entity957 ), 4 had @entity420 ( @entity420 ), 16 had @entity189 ( @entity189 ), and 19 had @entity2347 ( @entity2347 ). Eight @entity1 had T2, 36 had T3, and 53 had T4 @entity5 according to the 1997 AJCC staging system. Eleven @entity1 had nodal involvement at diagnosis: 9 with @entity957 , 1 with @entity189 , and 1 with @entity2347 . The most common sites of nodal involvement were ipsilateral level 1 and 2 lymph nodes. Thirty-six @entity1 were treated with definitive radiotherapy alone, and 61 received a combination of surgical and radiation treatment. Thirty-six @entity1 had neck irradiation, 25 of whom received elective neck irradiation (ENI) for N0 necks. The median follow-up for alive @entity1 was 78 months. RESULTS: The median survival for all @entity1 was 22 months (range: 2.4-356 months). The 5- and 10-year actuarial survivals were 34% and 31%, respectively. Ten @entity1 relapsed in the neck, with a 5-year actuarial risk of nodal relapse of 12%. The 5-year risk of neck relapse was 14% for @entity957 , 25% for @entity420 , and 7% for both @entity189 and ACC. The overall risk of nodal involvement at either diagnosis or on follow-up was 28% for @entity957 , 25% for @entity420 , 12% for @entity189 , and 10% for @entity2347 . All @entity1 with nodal involvement had T3-4, and none had T2 @entity5 . ENI effectively prevented nodal relapse in @entity1 with @entity957 and N0 neck; the 5-year actuarial risk of nodal relapse was 20% for @entity1 without ENI and 0% for those with elective neck therapy. There was no correlation between neck relapse and @entity5 control or @entity5 extension into areas containing a rich lymphatic network. The most common sites of nodal relapse were in the ipsilateral level 1-2 nodal regions (11/13). @entity1 with nodal relapse had a significantly higher risk of distant @entity3 on both univariate (p = 0.02) and multivariate analysis (hazard ratio = 4.5, p = 0.006). The 5-year actuarial risk of distant relapse was 29% for @entity1 with neck control versus 81% for @entity1 with neck failure. There was also a trend for decreased survival with nodal relapse. The 5-year actuarial survival was 37% for @entity1 with neck control and 0% for @entity1 with neck relapse. CONCLUSION: The overall incidence of lymph node involvement at diagnosis in @entity1 with @entity1177 was 9%. Following treatment, the 5-year risk of nodal relapse was 12%. @entity957 histology was associated with a high incidence of initial nodal involvement and nodal relapse. None of the @entity1 presenting with @entity957 histology and N0 necks had nodal relapse after elective neck irradiation. @entity1 who had nodal relapse had a higher risk of distant @entity3 and poorer survival. Therefore, our present policy is to consider elective neck irradiation in @entity1 with T3-4 @entity957 of the maxillary sinus.
