Contemporary management of the neck in nasopharyngeal carcinoma

Head Neck. 2021 Jun;43(6):1949-1963. doi: 10.1002/hed.26685. Epub 2021 Mar 29.


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.

Keywords: nasopharyngeal carcinoma; nodal metastasis; prognosis; radiotherapy; staging; surgery.

Publication types

  • Review

MeSH terms

  • Carcinoma* / therapy
  • Humans
  • Lymphatic Metastasis
  • Nasopharyngeal Carcinoma / radiotherapy
  • Nasopharyngeal Neoplasms* / pathology
  • Nasopharyngeal Neoplasms* / radiotherapy
  • Neck / pathology
  • Neoplasm Staging