Body Mass Index And Survival Rate in Nasopharyngeal Cancer Patient: An Evidence-based Case Report

Introduction: Nasopharyngeal cancer is the most common type of head and neck cancer with prevalence of 6.2/100000 population. Recently, study of prognostic factors for nasopharyngeal cancer still becomes one of research focuses. Several studies have tried to find the relationship between nutritional status (body mass index/BMI) and nasopharyngeal cancer patients’ survival rate, but the results are still inconsistent.                    Objective: To find the relationship between nutritional status represented by BMI and nasopharyngeal cancer patients’ survival rate.Methods: Electronic literature searches were performed in Cochrane®, Scopus®, and Pubmed®. Mesh term and title/abstracts were screened based on inclusion and exclusion criteria before relevant journals were reviewed.Results: Two articles were selected based on the eligibility criteria and relevancy to the clinical question. In the study of Huang et al., the subject was nasopharyngeal cancer patient stage III and IV was included as subject of the study. In the study of Lin et al., nasopharyngeal cancer patient with metastases was also included. Patient with higher BMI has better survival rate than underweight BMI category.Conclusion: Increasing BMI in underweight cancer patient simproves nasopharyngeal cancer patient’ survival rate

Nasopharyngeal cancer in north-eastern Nigeria: clinical trends

Nasopharyngeal cancer is the malignancy of the posterior aspect of the nose called Nasopharynx. It is one of themost difficult diseases to diagnose at an early stage. To determine prevalence, clinical trends and histopathological types of Nasopharyngeal cancer in Maiduguri, North Eastern Nigeria. Fifteen year retrospective evaluation of patient’s case notes and cancer registry records of 40 patientswith histologically confirmed nasopharyngeal cancer between 1991-2005. Nasopharyngeal cancers constituted 35.1% of all malignancies of ear, nose, throat during the study period.TheM:Fwas 2.1-1, themean agewas 39( 16.5) years and a peak age group and its occurrence of 40-49 years. The commonest symptom at presentation were cervical lymphadenopathy (72.5%), rhinorrhoea (55%), epistaxis(45%). The commonest histological type was squamous cell carcinoma(92.5%). Patients who received chemotherapy in addition to radiotherapy and higher symptom free period. Cancer is a difficult disease to diagnose at an stage.Ameticulous ear, nose and throat examination and thorough evaluation of nasal symptoms with associated cervical lymphadenopathy may lead to an early diagnosis of nasopharyngeal cancer’s.Keywords: Nasopharyngeal cancer, clinical trend, Maiduguri, Nigeria

PERBEDAAN KADAR HEMOGLOBIN PADA PASIEN KARSINOMA NASOFARING SEBELUM dan SETELAH RADIOTERAPI: (Studi Observasional di RSUP Dr Kariadi Semarang)

Background: Hemoglobin can be used as an indicator of a decline in nutritional status. Radiotherapy can lead to decreased nutritional status in patients with nasopharyngeal cancer. This study aimed to prove the existence of differences in hemoglobin concentration in nasopharyngeal cancer patients before and after radiotherapy. Methods: This study used a retrospective design, whose sample were nasopharyngeal cancer patients who seek treatment at Dr Kariadi were taken vulnerable time in the years 2006-2010. The data has been retrieved and processed by using SPSS computer program. Analysis of data in this study included descriptive analysis and hypothesis testing. Test hypothesis using Wilcoxon test with data not normally distributed. Degree of significance is p ≤ 0.05. Results: The variable data is not normally distributed, then the analysis used Wilcoxon test. This study found no significant differences in hemoglobin concentration in patients with nasopharyngeal cancer before and after radiotherapy with p 0.056. Conclusion: There were no significant changes in hemoglobin concentration in nasopharyngeal cancer patients before and after radiotherapy in Dr. Kariadi. Keywords: Hemoglobin content, Radiotherapy, Nasopharyinx cancer

A global view of the oncogenic landscape in nasopharyngeal carcinoma : an integrated analysis at the genetic and expression levels

Previous studies have reported that the tumour cells of nasopharyngeal carcinoma (NPC) exhibit recurrent chromosome abnormalities. These genetic changes are broadly assumed to lead to changes in gene expression which are important for the pathogenesis of this tumour. However, this assumption has yet to be formally tested at a global level. Therefore a genome wide analysis of chromosome copy number and gene expression was performed in tumour cells micro-dissected from the same NPC biopsies. Cellular tumour suppressor and tumour-promoting genes (TSG, TPG) and Epstein-Barr Virus (EBV)-encoded oncogenes were examined. The EBV-encoded genome maintenance protein EBNA1, along with the putative oncogenes LMP1, LMP2 and BARF1 were expressed in the majority of NPCs that were analysed. Significant downregulation of expression in an average of 76 cellular TSGs per tumour was found, whilst a per-tumour average of 88 significantly upregulated, TPGs occurred. The expression of around 60% of putative TPGs and TSGs was both up-and down-regulated in different types of cancer, suggesting that the simplistic classification of genes as TSGs or TPGs may not be entirely appropriate and that the concept of context-dependent onco-suppressors may be more extensive than previously recognised. No significant enrichment of TPGs within regions of frequent genomic gain was seen but TSGs were significantly enriched within regions of frequent genomic loss. It is suggested that loss of the FHIT gene may be a driver of NPC tumourigenesis. Notwithstanding the association of TSGs with regions of genomic loss, on a gene by gene basis and excepting homozygous deletions and high-level amplification, there is very little correlation between chromosomal copy number aberrations and expression levels of TSGs and TPGs in NPC

Stage T4B head and neck cancer survival outcome comparisons based on treatment modality: is surgery a viable treatment option?

IMPORTANCE: Advanced stage head and neck cancers are often deemed unresectable due to the aggressive nature of the cancer. In evaluating survival patterns of patients with stage IVb tumors, it is valuable to determine whether patients who undergo oncological surgery have favorable outcomes in order to deem surgery as a viable treatment option and demonstrate that these patients can survive with adequate treatment. OBJECTIVE: To determine whether patients with stage IVb cancers who undergo oncological surgery have favorable survival outcomes. MATERIALS AND METHODS: Of 320 cases reviewed of patients treated for head and neck cancer at Boston Medical Center between June 2009 and October 2014, 18 patients with stage IVb tumors were identified. Information regarding date of initial diagnosis, date and type of treatment, and date of death were extrapolated from medical records. Mean survival rates were calculated to compare survival outcomes of those who received and those who did not receive surgical intervention. RESULTS: The mean survival rate for patients who underwent surgical intervention was found to be 29.5 months while those who did not receive surgical intervention had a mean survival of 20.83 months. CONCLUSION: Cancers of the head and neck are associated with poor prognoses and are often deemed unresectable. Patients should be offered definitive treatment despite recommended palliative treatment, as, with adequate treatment, favorable survival outcomes are attainable

Nasopharyngeal Melanoma

Mucosal nasopharyngeal melanoma is a rare head and neck melanoma. Prognosis is poor (5-year overall survival rate of 10–30%) with high rates of metastases and local recurrence. Head and neck mucosal melanoma represents 0.8–3.7% of all melanomas and 0.03% of all neoplasms; the most commonly involved sites are the nose, paranasal sinuses, oral cavity, pharynx, and larynx. A slight female predominance has been described and the median age of presentation is 64.3. Irritants and carcinogenic substances, such as tobacco smoke and formaldehyde, seem to be related to its development. A lack of specific clinical features often leads to a late diagnosis. At an early stage, clinical features can include epistaxis, obstruction, difficulty breathing, serous otitis media, and nasal discharge; subsequently, pain, facial distortion, proptosis, and diplopia predominate the clinical pictures. Masses are mostly polyploid, friable, and bloody. They can be amelanotic or surrounded by black- or brown-pigmented dots. Nasopharyngeal melanoma resembles other common polypoid lesions; therefore, histology plays a pivotal role in confirming the diagnosis. Computed tomography, facial and total body scan, as well as magnetic resonance imaging are mandatory for a correct staging. Surgical treatment remains the gold standard. External or intranasal incision depends on tumor site and size. Sentinel lymph node biopsy is not usually performed. Neck dissection is indicated in cases of clinical and/or radiological positivity. Radiotherapy is mostly palliative, as radiotherapy lacks efficacy for mucosal melanomas. The effectiveness of target therapy and/or immunotherapy is undergoing evaluation

Nasopharyngeal cancer mimicking otitic barotrauma in a resource-challenged center: a case report

<p>Abstract</p> <p>Introduction</p> <p>Nasopharyngeal cancer commonly manifests with cervical lymphadenopathy, recurrent epistaxis and progressive nasal obstruction. Neuro-ophthalmic and otologic manifestations can also occur. Isolated otologic presentations of nasopharyngeal cancer are rare and the diagnosis of nasopharyngeal cancer may not be foremost in the list of differentials.</p> <p>Case presentation</p> <p>We present the case of a 29-year-old Nigerian woman with bilateral conductive hearing loss and tinnitus after air travel. There were no other symptoms. The persistence of the symptoms after adequate treatment for otitic barotrauma necessitated re-evaluation, which led to a diagnosis of nasopharyngeal cancer.</p> <p>Conclusion</p> <p>Isolated otologic manifestations of nasopharyngeal cancer are rare in regions with low incidence of the disease. There is a need for it to be considered as a possible differential in patients presenting with bilateral serous otitis media.</p