Nasopharyngeal carcinoma: Clinical assessment and review of 176 cases

Abstract

Objective: The objective of this study was to delineate salient disease characteristics and to determine factors associated with survival in a series of patients with nasopharyngeal carcinoma (NPC). Study Design: To address our research objective, we used a retrospective cohort study design and a sample of patients who presented for evaluation and management of NPC. Demographic data, medical history, radiographic findings, staging, and histology were recorded. Treatment and follow-up information were ascertained. Survival data and descriptive statistics were calculated. Multivariate analyses identified risk factors associated with survival rates for all World Health Organization (WHO) types. Results: The sample comprised 123 men and 53 women (n = 176) of which 70% were white and 23% were Asian. A neck mass was the initial symptom in 49% of patients. In 99% of cases, radiation therapy was the primary treatment mode. WHO types 1 and 3 were most common. Overall 5-year disease-free survival rate was 45.5%. Age, use of tobacco or ethanol, and number of presenting symptoms were statistically associated with decreased survival rate in WHO 1 (squamous cell) tumors. Male gender and total number of presenting symptoms were associated with decreased survival rate for WHO 2 and 3 (nonkeratinizing or undifferentiated) tumors. Conclusions: Being attuned to the presenting signs of NPC may lead to a more expedient diagnosis. The differing risk factors associated with WHO 1 tumors become clear in this predominantly white population. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:205-14)