Nasopharyngeal carcinoma: an evaluation of 209 patients

Abstract

A unique racially balanced North American series of 209 patients with nasopharyngeal carcinoma will be presented. The patients were 49% Chinese and 51% non-Chinese (predominantly caucasian). Whereas Chinese born in China had a 117.9 times greater incidence of the disease, North American born Chinese showed only a 7.3 times greater incidence than Caucasians. Five year absolute (NED) survival was 25.6% for Chinese and 32% for non-Chinese. Other racial differences are also discussed. Two four-year-old patients with definite nasopharyngeal carcinoma, the youngest in the literature, are included in the study. Survival and prognosis of nasopharyngeal carcinoma depends on tumor histology, initial stage of disease, dose of radiation and pre-irradiation node biopsy. Five year absolute survivals for different histologies were; lymphoepithelioma 52.4%, non-keratinizing squamous cell 31.5% and keratinizing squamous cell 16.3%. The overall 5 year absolute survival for the series was 29%. When initial primary disease was localized to the nasopharynx (T0, T1, T2) with or without mobile nodes (N0, N1, N2) the survival rose to 41%. Cases treated with 6000 rads or more primarily had the best survival results. Pre-irradiation node biopsy consistently resulted in poorer survival. When the nodes were mobile (N1, N2) the survival rate was 46.9% 5 year NED in the non-biopsied group and 25% 5 year NED when nodes were excised prior to primary irradiation therapy.