Pediatric Nasopharyngeal Carcinoma: A Review of 27 Cases over 10 Years at Shaukat Khanum Memorial Cancer Hospital and Research Center, Pakistan

Purpose: This study aims to review the clinical features, treatment and outcome of pediatric nasopharyngealCarcinoma at Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH&RC) over tenyears.
Methods: Retrospective review of pediatric patients who were diagnosed with nasopharyngeal carcinomaand treated at SKMCH&RC from July 1996 to June 2006.
Results: A total of 27 children with NPC wereincluded. The male to female ratio was 4.4:1. The mean age at diagnosis was 14 years (8-18 years). The mostcommon presenting symptom was neck swelling (81.5%, 22/27). The mean duration of symptoms before diagnosiswas 10.3 months (3-36 months). The majority of patients (70%, 19/27) presented at stage IV. All received acombination of chemotherapy and radiotherapy. Survival analysis was performed for 22 patients; of these 8patients died and 4 were lost to follow-up. The median follow-up time of the surviving patients was 53 months(5-116 months). At 5 years, the cumulative overall survival (OS) was 55% while the cumulative EFS was 54%with a flattening of the curve at 2 years. There was a significant difference in OS (p=0.001) and EFS (p=0.057) inpatients diagnosed with NPC under 14 years of age (n=11) and those between 14 and 18 years (n=11).
Conclusion:In our institutional study, NPC presents late and in advanced stage. The outcome is better in younger children.Our survival rates, while comparable to developing countries, are less than those seen in the developed world.We feel a strong need for collaborative studies in view of small numbers in individual centres.