Nasopharyngeal Malignant Tumors: 82 Consecutive Patients Treated in a Period of Twenty-Two Years

Abstract

THIS PUBLICATION is based on the study of 82 consecutive cases of malignant nasopharyngeal tumors treated from 1932 to 1954 in the Department of Radiology of the University of California, San Francisco. All were histologically verified and followed. Incidence The incidence of malignant nasopharyngeal tumors is estimated at 1 to 2 per cent of all cancers (13, 16, 22). Of a total of 3,353 patients treated for malignant diseases at the University of California during the years covered by the study, 614 had malignant tumors of the head and neck. The 82 cases reported thus represent 2.4 per cent of 3,353 treated cancer cases and 13.3 per cent of 614 head and neck tumors (Table I). Fifty-eight patients in the series were men (71 per cent), 24 were women: a ratio of 5:2. This coincides closely with the ratio of males and females reported by others (13, 15, 16, 25, 27) (Table II). Digby (8), in 1941, reported a high incidence of malignant nasopharyngeal tumors among Chinese, even when compared to carcinoma of the cervix or breast. In Formosa, Yeh and Cowdry (34) discovered nasopharyngeal carcinomas to be exceeded in number only by genital cancers. This high incidence also occurs among the Indonesians of Surabaja and vicinity (9). Lenz's series from Presbyterian and Monte-fiore Hospitals, New York City, included 4 Chinese among 63 nasopharyngeal patients (6.4 per cent) (15). According to the 1950 census report (33), the New York City Chinese population (18,327) comprises 0.25 per cent of the total 7,891,957. Martinez (18) found that of 69 patients with nasopharyngeal cancer at the Cancer Institute of Havana, 29 per cent were Chinese. The 1943 Cuban census reported 6,539 Chinese in Havana's 659,883 population (0.99 per cent) (32). Of our 82 patients, 13 were Chinese and 1 was Korean. Nine of these patients were born in China, 1 was born in the United States, and the birthplace of 3 was not recorded. This high incidence (17 per cent) is compatible with the previously reported frequency of nasopharyngeal tumors in Chinese and the large Chinese population in San Francisco. The San Francisco Chamber of Commerce in 1957 estimated that 30,000 (3.7 per cent) of the 814,000 San Francisco inhabitants were Chinese (Table III). The ages of our patients ranged from two to seventy-seven years, with an average of 49.6 years. The average age of the men was 49.9 years, of women 49.1 years. This figure is in agreement with those of other authors (11, 13, 15, 16, 22, 25, 27). Fifty-four of the treated patients were in the forty- to sixty-year age group (Fig. 1). Symptoms And Signs Enlarged cervical lymph nodes constituted the initial and only complaint in 24 (29.3 per cent) of our patients and in an additional 15 were associated with other symptoms. On examination, however, cervical adenopathy was found unilaterally in 34 patients and bilaterally in 25. It was absent in only 23 patients.