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Distant metastases from nasopharyngeal carcinoma at Kenyatta National Hospital, Nairobi
Objectives:
To determine the frequency and site of distant infraclavicular metastases of nasopharyngeal carcinoma (NPC), the stage of the primary tumour at presentation of metastasis and the histological trends. To determine if there is a correlation between the follow-up rate and different metastatic sites.
Design:
A retrospective study.
Setting:
Ear nose and throat surgical and radiotherapy clinics at Kenyatta National Hospital, Nairobi.
Subjects:
Case notes, radiotherapeutic and laboratory records of patients presenting with NPC between January 1981 and December 1990.
Results:
The frequency of distant NPC metastases was 14.6% and 92.3% manifested within 24 months of admission. It was most frequent in the males, a younger age group and early T1 disease. Bilaterality of the neck nodes had no relevance on metastatic rate. The bone (66.7%) was the most common distant metastatic destination followed by the liver (23.2%). Liver metastasis was associated with a shorter follow-up period.
Conclusion:
Apart from the late presentation of locoregional disease, the findings are similar to studies elsewhere. The preponderance of early primary disease in patients with distant metastasis need further appraisal as it preliminarily suggests existence of specific biological markers that favour metastases. This can only be done after recruiting more cases.