Primary emergence, regional recurrence, and distant metastasis
A summary of primary emergence, recurrence and distant metastasis is presented in table 3. Twelve of the studies reported on primary emergence with reported rates between 1.5% and 21.8%. These studies included a total of 117 emergences in 1007 patients (11.6%). Primary emergence rates in patients having ND only were reported in seven studies (n=157) and ranged from 11.1-33.3%. Sites of primary emergence were reported on in 10 studies; but only three studies discerned sites of primary emergence in patients receiving ND only from the whole cohort. There were 95 primary site emergences reported in 823 patients, sites were as follows: 32 oropharynx (3.9%), 19 hypopharynx (2.3%), 18 nasopharynx (2.2%), 7 larynx (0.9%), 5 oesophagus (0.6%), 4 supraglottic (0.5%), 4 oral cavity (0.5%), 3 sino-nasal (0.4%), 3 lung (0.4%). Amongst those reporting on site of primary emergence for ND alone (n=82) there were: 8 hypopharynx (7.2%), 6 nasopharynx (7.3%), 6 oropharynx (7.3%), 3 larynx (3.7%), and 1 oral cavity (1.2%).
Eleven studies reported on nodal relapse rates overall, with rates varying from 8.7% to 42.0%. These studies included a total of 184 regional recurrences in 932 patients (19.7%). Five studies (n=60) reported on nodal relapse rates for ND alone and rates varied from 0.0% to 50.0%. 11 studies reported on distant metastasis with overall rates ranging from 1.5% to 36.2%, amongst the ND only patients, only three studies (n=45) reported, with rates of 0-3.3%.