Clinical features of 337 patients with recurrent nasopharyngeal carcinoma

Jia-Xin Li , Tai-Xiang Lu, Ying Huang, Fei Han, Chun-Yan Chen, Wei-Wei Xiao

State Key Laboratory of Oncology in South China,Guangzhou, 510060, Guangdong, P. R. China. lutx@mail.sysu.edu.cn

[Abstract] Background and Objective: At present, although appropriate radiotherapy and normative comprehensive treatment are widely used in the clinical treatment of primary nasopharyngeal carcinoma (pNPC), it is hard to avoid the recurrence of local-region in nasophaynx and/or neck lymph nodes in a part of patients after active treatment. According to the clinical performance and pathologic examination and imaging for diagnosis of patients with recurrent nasopharyngeal carcinoma (rNPC) for the first time, this study was to analyze the clinical features of rNPC and to provide a reference for tracking the rules of recurrence after treatment of NPC patients. Methods: Clinical data of 337 patients diagnosed with rNPC for the first time on the base of pathology and/or imaging and treated in Sun Yat-sen University Cancer Center from Jan. 1999 to Dec. 2004, were collected according to clinical performance while visiting, the extension of invasion shown on imaging, features of pathology, Epstein-Barr virus serology, restaging, and so on for statistical analysis. Results: Patients of Stages I/II in UICC staging system(2002) accounted for 25.2%, while Stages III/IV accounted for 74.8%. Median interval of relapse was 25 months. Local recurrence accounted for 69.4%. Regional recurrence accounted for 4.5%. Local and regional recurrence accounted for 26.1%. Epistaxis and headache were the most common symptoms. Abduct dysfunction and facial numbness induced by cranial nerve damages were the most common signs. The probability of invasion of structures adjacent to nasopharynx, such as oropharynx, prestyloid space, and carotid sheath area, was lower in the rNPC than in the pNPC. By contrast, the probability of invasion of structures far from nasopharynx, such as skull base, paranasal sinuses, cranial nerves, cavernous sinus, brain, pterygopalatine fossa, infratemporal fossa, orbital apex and soft palate, was higher in the rNPC than in the pNPC. Conclusion: The most common interval of relapse is about two years. The relapsed disease is usually more widespread and located deeper. Most rNPC is advanced disease.

Chinese Journal of Cancer 2010, Volume: 29, Issue 1, Page: 76-

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