Undifferentiated carcinoma of nasopharyngeal type in children: Clinical features and outcome

To describe the epidemiology, clinical features and treatment of undifferentiated carcinoma of nasopharyngeal type in children.

Retrospective study of 40 patients under the age of 17 years managed for undifferentiated carcinoma of nasopharyngeal type in two oncology centres in the central region of Tunisia between 1995 and 2012.

Patients had a median age of 14 years with a sex ratio of 1.3. The mean time to presentation was 5 months. The presenting complaint was cervical lymphadenopathy in 90% of cases. Thirty-seven patients received curative treatment, according to a sequential mode in 85% of cases, starting with chemotherapy followed by radiotherapy to the nasopharynx and cervical lymph nodes. The median dose delivered to the nasopharynx was 70.4Gy. Two cases of local recurrence and five cases of metastatic relapse (all involving bone), were observed during follow-up. After a mean follow-up of 80.5 months (range: 1 to 180), 29 patients (72.5%) were in complete remission, eight had died and three were lost to follow-up. The 5-year overall survival was 77.7%.

Undifferentiated carcinoma of nasopharyngeal type in children represents 6% of all cases of UCNT managed in our institutions. It is often discovered at an advanced stage. Sequential treatment combining chemotherapy and radiotherapy achieves an excellent local control rate.