[Carcinoma of the nasopharynx (cavum) : clinical and developmental aspects]

Between 1959 and 1974, two hundred and ninety six carcinomas of the nasopharynx were seen at the Institut Gustave-Roussy, in adults. 78% were in man. The most frequently encountered were undifferentiated or poorly differentiated forms, 76% of cases. 38% only of the patients had their birthplace in France. On the first examination 36% of the cases had a T4 tumour, 50% had fixed cervical lymph nodes and 77% had distant metastases. 30% of the cases could not be treated following a protocol attempting complete cure. Since 1970 the Iridium method of irradiation is not used in T1 and T2 cases and all were treated by high voltage methods with eventual complementary surgical treatment for persistent nodes. The survival rate at 5 years is 30% for the whole group and 37% for the determinated group. Failures were encountered by local recurrence present in 58% of those dying of the disease and distant metastases were found in 37%. 20% of the patients died from distant metastases without local and regional lymph node recurrences. Unfavourable prognostic factors are initial involvement in bone and the differentiated histological type. It was noteworthy that associated multiple cancers were rare.