[Prognostic value of the parapharyngeal space involvement in nasopharyngeal carcinoma]

ABSTRACT

This study evaluated the prognostic value of the Para pharyngeal space involvement in nasopharyngeal carcinoma T 2 disease [UICC 1997 classification]. From January 1997 and December 20G1 32 patients with nasopharyngeal carcinoma were examined by CT scan and according to the 1997 International Union Against Cancer [UICC] staging system 15 had stage T2a MO [G1] and 17 T2hMO[G2]. The median age was 47 years .The male to female ratio was 1.81 [G1]; 4.3[G2] All patients were pathologically confirmed by biopsy from the nasopharynx as having UCNT in 100%[G1] and 94%[G2].The node involvement was 52%for the GI[N2 26%, N3 26%] and 80%for the G2[N2 47%, N3 41%]. Both neoadjuvant chemotherapy and radiotherapy were performed for advanced N disease and only radiotherapy for NO. Examination and CT scan were performed for the evaluation of the treatment. The completely clinical remission after chemotherapy was 12.5%[G1] and 53%[G2], partial remission was 25%[G1] and 35%[G2]. The CT scan control wasn't performed for all patients. The complete response was 69%[G1] and 53%[G2] partial response was 6%for both two groups. The median follow op was 79 months. Disease free survival rates were 70%for G1 [T2a] and 48%for G2 T2b]. Distant metastasis rates were 26%[G1] vs 6%[G2] and more likely in the presence of advanced N disease. Five years overall survival was 78%[G1] T2a vs 55%[G2] T2b.The N disease was correlated to metastasis as overall survival was 66.7%for N3 disease vs 85.7%for NO. Parapharyngeal tumor involvement affects local and regional tumor failure. Subclassification of T2 disease into T2a112b should have an impact on treatment strategies