Staging computed tomography of the thorax for nasopharyngeal carcinoma

Head Neck. 2000 Jul;22(4):369-72. doi: 10.1002/1097-0347(200007)22:4<369::aid-hed9>;2-2.


Background: To assess the role of staging CT of the thorax in advanced nodal stage nasopharyngeal carcinoma and to examine the hypothesis that contiguous spread of nodal metastases from the supraclavicular region to the upper mediastinal region occurs in this cancer.

Methods: Forty-four patients with newly diagnosed nasopharyngeal carcinoma with neck node metastases to the supraclavicular region (ie, AJCC N3b stage) underwent contrast-enhanced CT (CECT) thorax for staging. CT findings and clinical outcome were analyzed.

Results: No patient was found to have intrathoracic metastasis, although 1 had hepatic metastases on CECT of the thorax, resulting in upstaging in 1 of 44 (2%) of patients. With a median follow-up time of 21 months, 3 patients had lung metastases and 2 had axillary nodal metastases develop without evidence of upper mediastinal nodal metastases.

Conclusion: Staging CECT of the thorax has a very low yield in nasopharyngeal carcinoma, even in advanced nodal disease. The hypothesis that contiguous spread of nodal metastases from the supraclavicular region to the upper mediastinum is not substantiated, and no evidence suggests that radiation therapy for N3b-stage disease needs to encompass the upper mediastinum.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Axilla / diagnostic imaging
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / secondary
  • Carcinoma / diagnostic imaging*
  • Carcinoma / secondary*
  • Contrast Media
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Neoplasms / classification
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / secondary
  • Lung Neoplasms / classification
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / secondary
  • Lymph Nodes / diagnostic imaging
  • Lymphatic Metastasis
  • Male
  • Mediastinum / diagnostic imaging
  • Middle Aged
  • Nasopharyngeal Neoplasms / classification
  • Nasopharyngeal Neoplasms / pathology*
  • Neoplasm Staging / methods
  • Radiographic Image Enhancement
  • Sensitivity and Specificity
  • Thoracic Neoplasms / classification
  • Thoracic Neoplasms / diagnostic imaging*
  • Thoracic Neoplasms / secondary*
  • Tomography, X-Ray Computed / methods*


  • Contrast Media