Prognostic factors of nasopharyngeal carcinoma: a review of 759 patients.

The records of 759 Stage I to IV nasopharyngeal carcinoma patients seen between January 1976 and December 1983 were reviewed. There were 72 (9.5%), 162 (21.3%), 317 (41.8%) and 208 (27.4%) patients with Stage I, II, III and IV disease, respectively. Ho's stage classification was found to give a reliable prognosis. The actuarial survival at 5 and 10 years for Stage I, II, III and IV disease was 80.8%, 71.5%, 40.7%, 17.7% and 33.4%, 48.4%, 30.0%, 9.5%, respectively. The significant factors affecting survival were found using Cox multivariate analysis, N and T stages, the size and degree of fixation of neck nodes, sex, age, the presence of cranial nerve palsy and ear symptoms at presentation. Bilateral neck node involvement, histology subtypes of tumour, headache and nasal symptoms at presentation, the difference in radiation dose to the primary tumour and the neck, the initial haemoglobin and white blood count were not significant factors in the present study. The N stage was found to be prognostically significant even among patient groups stratified for the size and degree of fixation of the neck nodes involved. Women had a better survival rate than men, and the survival of patients less than 40 years old was better than those who were older at 5 years, although by 10 years the survival for the two groups was comparable.