Nasopharyngeal Carcinoma: Profile, Challenges and 5-Year Outcome in a Nigerian Tertiary Hospital

BACKGROUND: Nasopharyngeal carcinoma is encountered regularly in otolaryngological practice in Nigeria. However, it is often misdiagnosed due to varied presenting symptoms, hence the need to describe the pattern of presentation and the challenges of treatment of the patients that presented to our centre with nasopharyngeal carcinoma. METHODS: The pathology and clinical records were retrieved for all histologically confirmed cases of nasopharyngeal carcinoma from the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) cancer registry. The epidemiological data, symptoms and stage at presentation, type of treatment, outcome and challenges encountered were obtained from the records. RESULTS: A total of 384 histologically confirmed head and neck malignancies were seen over the review period, and nasopharyngeal carcinoma constituted 32 (8.33%). There were 24(75.0%) male and 8(25.0%) female. The age ranged from 17 - 80 years with a mean of 54.5 + 12.2 years. All the patients presented with neck swelling, Nasal obstruction 14(43.75), Epistaxis 11(37.5%), Trismus 2(6.25%), and proptosis 2(6.25%). Twenty-four (75%) presented with stage four tumour. Treatment was primarily radiotherapy. Fifteen (46.88%) completed radiotherapy. Two (6.25%) patients had chemo-radiation and 15(46.88%) defaulted at different stages of treatment mainly due to financial constraints, others include beliefs and breakdown of radiotherapy machines. Prognosis was very poor with 1-year survival of 21.9% and five-year survival of 9.25%. Conclusion: Neck swelling, Epistaxis and nasal blockade are the most common presenting symptoms. Patients present late leading to poor prognosis. Financing treatment out of pocket is a major reason for presenting late and defaulting during management.