Distant metastases in nasopharyngeal carcinoma

Three hundred and fifty-two consecutive cases of nasopharyngeal carcinoma were analysed to determine the pattern of distant metastases. Diagnosis of distant metastases was made wholly on clinical signs and radiography. Ninety-nine patients developed distant metastases, an incidence rate of 28.1%. There did not appear to be any difference in "risk" by age or sex. The predilection of this cancer to develop skeletal metastases is further confirmed. Pulmonary and hepatic involvement were the next commonest. Both extent of primary tumour (T) and cervical lymph node status (N) exerted a significant influence on the probability of metastases developing. Thus significant differences in metastatic rate were observed between T0/T1, T2 and T3/T4 and N0, N1, N2 and N3 groups. 65.6% of metastatic cases had control of local disease (nasopharynx and cervical lymph nodes). When metastases are diagnosed the prognosis is gloomy with a median survival under four months and a fatality rate of 91% within a year of first metastasis.