Radiology, Vol 144, 905-908, Copyright © 1982 by Radiological Society of North America
Advanced carcinoma of the nasopharynx. A clinical study of 274 patients
Z Petrovich, JD Cox, B Roswit, R MacKintosh, R Middleton, M Ohanian, Y Rao, RW Byhardt, C Paig and JA del Regato
A total of 274 patients with a diagnosis of nasopharyngeal carcinoma was
treated in eight Veterans Administration Hospitals over a period of 22
years. Of the 274 patients, 256 (93%) had squamous-cell carcinoma, while 18
(7%) had other tumors. Most of the squamous-cell carcinoma patients (82%)
had Stage IV disease; cervical lymph node metastases were found in 193
(75%), and distant metastases were present in 22 (9%). The actuarial 5-,
10-, and 15-year survival rates for the 256 squamous-cell carcinoma
patients were 15%, 10%, and 7%, while they were 49%, 42%, and 35% for the
18 patients with other tumors (p = 0.006). There was a progressive decrease
in 5-year survival with the increase in the stage of tumor. The survival of
the 63 patients without metastases was better than the survival of the 193
patients with cervical metastases (24% vs. 12% at 5 years, p = 0.03). The
presence of T4 disease or Initial Performance Status of less than 80 on the
Karnofsky Scale indicated a poor prognosis (p = 0.0001). Treatment failure
occurred in 83% of the patients by 2 years after therapy and was due to the
lack of tumor control at the primary site. Advanced (N3) cervical lymph
node metastases indicated that systemic tumor dissemination of the
nasopharynx is an uncommon malignancy.
