Abstract 1214: Nasopharyngeal carcinoma clinical stage, histologic grade and biomarker status at presentation are usually of poor prognostic characteristics: A clinicopathologic study in a low-resource setting

Abstract

Abstract Introduction: Nasopharyngeal carcinoma (NPC) is the 8th commonest malignancy in men and the commonest head and neck tumor in Ibadan Cancer Registry (IBCR). Methods: Clinical files and records of all nasopharyngeal carcinoma diagnosed at the Department of Pathology, University College Hospital affiliated with IBCR between January 2007 and December 2016 were reviewed for demographic data, clinical presentation, clinical stage, histologic grade, LMP-1 and EGFR status. Results: A total of 71 cases of nasopharyngeal carcinoma were diagnosed during the study period, comprising 44 males and 27 females with a male:female ratio of 1.6. Age ranged from 12 years to 80 years, the modal age group was 40-49 and the modal age was 45 years. Sixty-three percent of cases were non-keratinizing undifferentiated tumors, 31% were non-keratinizing differentiated, 4.2% were keratinizing tumors and 1.4% basaloid squamous cell carcinoma. In all, non-keratinizing undifferentiated tumors constituted 64% of tumors in males and 63% in females. Conversely, non-keratinizing differentiated tumor was commoner in males, accounting for 34% of tumors compared to only 26% in females. Also, keratinizing tumor was twice as common in females than males; there was only a single basaloid squamous cell carcinoma recorded. The age group 30-39 years had the highest incidence of non-keratinizing undifferentiated tumor while non-keratinizing differentiated tumor was more common in the 40-49 age group. Patients presented most frequently with stage II disease, which accounted for 62% of cases. About 20% of these patients presented with stage IV disease. Nasal and aural symptoms accounted for the commonest presenting complaint, occurring in 38% of patients. Thirty-six percent presented with nasal symptoms alone while 13% had a combination of nasal, aural and visual symptoms; this group was mainly patients with stage IV disease. LMP-1 positivity was observed in as many as 99% of all cases. EGFR was positive in 94% of cases, indicating that NPCs are usually of poor prognosis in our practice setting at presentation. Conclusion: In our practice, nasopharyngeal carcinoma is characterized by late-stage presentation, high-grade histologic characteristics and have biomarker indicators of poor prognosis. Citation Format: Aralola A. Olusanya, Gabriel O. Ogun, Adebolajo Adeyemo. Nasopharyngeal carcinoma clinical stage, histologic grade and biomarker status at presentation are usually of poor prognostic characteristics: A clinicopathologic study in a low-resource setting [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1214.