CLINICAL CHARACTERISTICS OF PATIENTS WITH STAGE III – IVA UNDIFFERENTIATED NASOPHARYNGEAL CARCINOMA

Tóm tắt

Objective: To describe the clinical characteristics of patients with stage III–IVa undifferentiated nasopharyngeal carcinoma (NPC). Marterials and methods: A cross-sectional descriptive study was conducted on 84 undifferentiated type NPC patients. Results: Patient age ranged from 7 to 72 years, with a mean of 46.92 years; the 30–60 age group predominated, and the male-to-female ratio was approximately 2:1. The most common signs were cervical lymphadenopathy (38.1%), headache (32.1%), and tinnitus (27.4%), with onset mostly within three months (57.1%). The primary tumor was most frequently located at the posterior-superior wall of the nasopharynx (39.3%), with the exophytic type being the most common (52.4%). Bilateral cervical lymph nodes were observed in 64.3%, and 90.5% showed loss of the nodal hilum structure on imaging. Tumors frequently invaded the nasopharyngeal soft tissue (34.5%), skull base (28.6%), and cranial nerves/intracranial structures (21.4%). T3–T4 stages accounted for 64.2%, N2 stage for 47.6%, and TNM stages were evenly distributed between stage III (46.4%) and stage IVa (53.6%). Significant differences were found in age distribution, symptoms, tumor location, tumor morphology, and T–N stage (p < 0.05). cf EBV DNA concentration at stage IVA media was 3964.0copy/mL which was higher than at stage III ones with 2003.0 copy/mL. Most of patients in both groups were in the level > 4000 copy/ mL. Conclusions: Stage III–IVa undifferentiated NPC commonly occurs in men aged 30–60 years, characterized by bilateral cervical lymphadenopathy, exophytic primary lesions at the posterior-superior wall of the nasopharynx, extensive local invasion, and advanced nodal metastases, concentration of cf EBV DNA were mostly over 4000 copy/mL.