THE RELATIONSHIP BETWEEN THE INVASION OF PARAPHARYNGEAL SPACES AND THE INVOLVEMENT OF CERVICAL NODES AND POSTERIOR GROUP CRANIAL NERVES IN NASOPHARYNGEAL CARCINOMA

Two hundred cates of nasopharyngeal carcinoma (NPC) admitted to this department from Feb. 1985 to May. 1988 were analysed according to the CT scanning and clinical findings of the primary lesions prior to radiotherapy. The results showed that involvement of parapharyngeal space was very common in NPC, about 80% (160/200 cases) ; particularly unilateral or bilateral retro-styloid spaces, about 69.5% (139/200 cases). It was proposed that patients with NPC had a high Incidence of ipsilateral cervical node metastasis. Contralateral cervical node metastasis was rare. The development of cervical node metastasto in NPC has two modes: one Is direct Infiltration of the retro-stylold space by the lesion; the other Is along the nasopharyngeal lymphatic rete. The data also showed that patients with NPC who presented symptoms of Ⅸ- Ⅲ cranial nerve paralyses always had ipsilateral or bilateral retro- styloid space Infiltrations.

High body mass index predicts multiple prostate cancer lymph node metastases after radical prostatectomy and extended pelvic lymph node dissection

Our aim is to evaluate the association between body mass index(BMI)and preoperative total testosterone(TT)levels with the risk of single and multiple metastatic lymph node invasion(LNI)in prostate cancer patients undergoing radical prostatectomy and extended pelvic lymph node dissection.Preoperative BMI,basal levels of TT,and prostate-specific antigen(PSA)were evaluated in 361 consecutive patients undergoing radical prostatectomy with extended pelvic lymph node dissection between 2014 and 2017・Patients were grouped into either nonmetastatic,one,or more than one metastatic lymph node invasion groups.The association among clinical factors and LNI was evaluated.LNI was detected in 52(14.4%)patients:28(7.8%)cases had one metastatic node and 24(6.6%)had more than one metastatic node.In the overall study population,BMI correlated inversely with TT(r=-0.256;P<0.0001).In patients without metastases,BMI inversely correlated with TT(r=-0.282;P<0.0001).In patients with metastasis,this correlation was lost.In the overall study population,BMI(odds ratio[OR]=1.268;P=0.005)was the only in dependent clinical factor associated with the risk of multiple metastatic LNI compared to cases with one metastatic node.In the nonmetastatic group,TT was lower in patients with BMI>28 kg m^2(P<0.0001).In patients with any LNI,this association was lost(P=0.232).The median number of positive nodes was higher in patients with BMI>28 kg m^2(P-0.048).In our study,overweight and obese patients had a higher risk of harboring multiple prostate cancer lymph node metastases and lower TT levels when compared to patients with normal BMI.

Briganti’s 2012 nomogram is an independent predictor of prostate cancer progression in EAU intermediate-risk class:results from 527 patients treated with robotic surgery

The study aimed to test if Briganti’s 2012 nomogram could be associated with the risk of prostate cancer (PCa) progression in European Association of Urology (EAU) intermediate-risk patients treated with robotic surgery. From January 2013 to December 2021, 527 consecutive patients belonging to the EAU intermediate-risk class were selected. Briganti’s 2012 nomogram, which predicts the risk of pelvic lymph node invasion (PLNI), was assessed as a continuous and dichotomous variable that categorized up to the median of 3.0%. Disease progression defined as biochemical recurrence and/or metastatic progression was evaluated by Cox proportional hazards (univariate and multivariate analysis). After a median follow-up of 95.0 months (95% confidence interval [CI]: 78.5–111.4), PCa progression occurred in 108 (20.5%) patients who were more likely to present with an unfavorable nomogram risk score, independently by the occurrence of unfavorable pathology including tumor upgrading and upstaging as well as PLNI. Accordingly, as Briganti’s 2012 risk score increased, patients were more likely to experience disease progression (hazard ratio [HR] = 1.060;95% CI: 1.021–1.100;P = 0.002);moreover, it also remained significant when dichotomized above a risk score of 3.0% (HR = 2.052;95% CI: 1.298–3.243;P < 0.0001) after adjustment for clinical factors. In the studied risk population, PCa progression was independently predicted by Briganti’s 2012 nomogram. Specifically, we found that patients were more likely to experience disease progression as their risk score increased. Because of the significant association between risk score and tumor behavior, the nomogram can further stratify intermediate-risk PCa patients, who represent a heterogeneous risk category for which different treatment paradigms exist.