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Nasopharynx Carcinoma
Philip R. Chapman, MD
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6

OVERVIEW

  • General Comments

    • Classification

      PATHOLOGY

      • General Features

        • Microscopic Features

          • Routes of Spread

            • Gross Pathology & Surgical Features

              IMAGING FINDINGS

              • Detection

                • Staging

                  • Restaging

                    CLINICAL ISSUES

                    • Presentation

                      • Cancer Natural History & Prognosis

                        • Treatment Options

                          REPORTING CHECKLIST

                          • T Staging

                            • N Staging

                              • M Staging

                                Selected References

                                1. Chiang CL et al: Prognostic factors for overall survival in nasopharyngeal cancer and implication for TNM staging by UICC: a systematic review of the literature. Front Oncol. 11:703995, 2021
                                2. Li WZ et al: Assessment of survival model performance following inclusion of epstein-barr virus dna status in conventional tnm staging groups in epstein-barr Virus-Related Nasopharyngeal Carcinoma. JAMA Netw Open. 4(9):e2124721, 2021
                                3. Pan XB et al: Retropharyngeal lymph node metastasis on N stage of nasopharyngeal carcinoma. PLoS One. 16(6):e0253424, 2021
                                4. Cui C et al: Staging of T2 and T3 nasopharyngeal carcinoma: proposed modifications for improving the current AJCC staging system. Cancer Med. 9(20):7572-9, 2020
                                5. Glastonbury CM: Critical changes in the staging of head and neck cancer. Radiol Imaging Cancer. 2(1):e190022, 2020
                                6. Guo R et al: The evolution of nasopharyngeal carcinoma staging. Br J Radiol. 92(1102):20190244, 2019
                                7. Huang L et al: Prognostic value of retropharyngeal lymph node metastasis laterality in nasopharyngeal carcinoma and a proposed modification to the UICC/AJCC N staging system. Radiother Oncol. 140:90-7, 2019
                                8. King AD et al: Complementary roles of MRI and endoscopic examination in the early detection of nasopharyngeal carcinoma. Ann Oncol. 30(6):977-82, 2019
                                9. Ai QY et al: Staging nodal metastases in nasopharyngeal carcinoma: which method should be used to measure nodal dimension on MRI? Clin Radiol. 73(7):640-6, 2018
                                10. Chen YH et al: Value of early evaluation of treatment response using 18F-FDG PET/CT parameters and the Epstein-Barr virus DNA load for prediction of outcome in patients with primary nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging. 46(3): 650-60, 2018
                                11. Lee AW et al: International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma. Radiother Oncol. 126(1):25-36, 2018
                                12. Wu L et al: Nasopharyngeal carcinoma: a review of current updates. Exp Ther Med. 15(4):3687-92, 2018
                                13. Amin M.B. et al: AJCC Cancer Staging Manual. 8th Ed. Springer New York, 2017
                                14. Glastonbury CM et al: Setting the stage for 2018: how the changes in the American Joint Committee on Cancer/Union for International Cancer Control Cancer Staging Manual Eighth Edition impact radiologists. AJNR Am J Neuroradiol. 38(12):2231-7, 2017
                                15. Kang M et al: Validation of the 8th edition of the UICC/AJCC staging system for nasopharyngeal carcinoma treated with intensity-modulated radiotherapy. Oncotarget. 8(41):70586-94, 2017
                                16. Kang M et al: A new T staging system for nasopharyngeal carcinoma based on intensity-modulated radiation therapy: results from a prospective multicentric clinical study. Am J Cancer Res. 7(2):346-56, 2017
                                17. King AD et al: MR imaging criteria for the detection of nasopharyngeal carcinoma: discrimination of early-stage primary tumors from benign hyperplasia. AJNR Am J Neuroradiol. 39(3): 515-23, 2017
                                18. Naggar AK et al: Tumours of the nasopharynx. In WHO Classification of Head and Neck Tumours, 4th ed. Vol. 9. Lyon: International Agency for Research on Cancer. 63-76, 2017
                                19. Peng H et al: Significant value of 18F-FDG-PET/CT in diagnosing small cervical lymph node metastases in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy. Chin J Cancer. 36(1):95, 2017
                                20. Stelow EB et al: Update from the 4th edition of the World Health Organization classification of head and neck tumours: Nasopharynx. Head Neck Pathol. 11(1):16-22, 2017
                                21. Yan DF et al: The prognostic value of pretreatment tumor apparent diffusion coefficient values in nasopharyngeal carcinoma. BMC Cancer. 17(1):678, 2017
                                22. Fung SY et al: Clinical utility of circulating Epstein-Barr virus DNA analysis for the management of nasopharyngeal carcinoma. Chin Clin Oncol. 5(2):18, 2016
                                23. Wang HY et al: A new prognostic histopathologic classification of nasopharyngeal carcinoma. Chin J Cancer. 35:41, 2016
                                24. Zhang L et al: Plasma Epstein-Barr viral DNA complements TNM classification of nasopharyngeal carcinoma in the era of intensity-modulated radiotherapy. Oncotarget. 7(5):6221-30, 2016
                                25. Kamran SC et al: Nasopharyngeal carcinoma. Surg Oncol Clin N Am. 24(3):547-61, 2015
                                26. King AD et al: Detection of nasopharyngeal carcinoma by MR imaging: diagnostic accuracy of MRI compared with endoscopy and endoscopic biopsy based on long-term follow-Up. AJNR Am J Neuroradiol. 36(12):2380-5, 2015
                                27. Lan M et al: Prognostic value of cervical nodal necrosis in nasopharyngeal carcinoma: analysis of 1800 patients with positive cervical nodal metastasis at MR Imaging. Radiology. 276(2):536-44, 2015
                                28. Zhang W et al: The clinical utility of plasma Epstein-Barr virus DNA assays in nasopharyngeal carcinoma: the dawn of a new era?: a systematic review and meta-analysis of 7836 cases. Medicine (Baltimore). 94(20):e845, 2015
                                29. Shen G et al: Meta-analysis of diagnostic value of 18F-FDG PET or PET/CT for detecting lymph node and distant metastases in patients with nasopharyngeal carcinoma. Br J Radiol. 87(1044):20140296, 2014
                                30. Mosier KM: Skull base lesions: extracranial origins. Semin Ultrasound CT MR. 34(5):436-44, 2013
                                31. Abdel Khalek Abdel Razek A et al: MRI and CT of nasopharyngeal carcinoma. AJR Am J Roentgenol. 198(1):11-8, 2012
                                32. Ho FC et al: Patterns of regional lymph node metastasis of nasopharyngeal carcinoma: a meta-analysis of clinical evidence. BMC Cancer. 12:98, 2012
                                33. Li WF et al: Locoregional extension patterns of nasopharyngeal carcinoma and suggestions for clinical target volume delineation. Chin J Cancer. 31(12):579-87, 2012
                                34. King AD et al: Primary nasopharyngeal carcinoma: diagnostic accuracy of MR imaging versus that of endoscopy and endoscopic biopsy. Radiology. 258(2):531-7, 2011
                                35. King AD et al: Magnetic resonance imaging staging of nasopharyngeal carcinoma in the head and neck. World J Radiol. 2(5):159-65, 2010
                                36. Goh J et al: Imaging of nasopharyngeal carcinoma. Ann Acad Med Singapore. 38(9):809-16, 2009
                                37. Chong VF et al: Nasopharyngeal carcinoma. Eur J Radiol. 66(3):437-47, 2008
                                38. Ou SH et al: Epidemiology of nasopharyngeal carcinoma in the United States: improved survival of Chinese patients within the keratinizing squamous cell carcinoma histology. Ann Oncol. 18(1):29-35, 2007
                                39. Thompson LD: Update on nasopharyngeal carcinoma. Head Neck Pathol. 1(1):81-6, 2007
                                40. Wenig BM: Squamous cell carcinoma of the upper aerodigestive tract: precursors and problematic variants. Mod Pathol. 15(3):229-54, 2002
                                41. Chong VF et al: Carcinoma of the nasopharynx. Semin Ultrasound CT MR. 19(6):449-62, 1998
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                OVERVIEW

                                • General Comments

                                  • Classification

                                    PATHOLOGY

                                    • General Features

                                      • Microscopic Features

                                        • Routes of Spread

                                          • Gross Pathology & Surgical Features

                                            IMAGING FINDINGS

                                            • Detection

                                              • Staging

                                                • Restaging

                                                  CLINICAL ISSUES

                                                  • Presentation

                                                    • Cancer Natural History & Prognosis

                                                      • Treatment Options

                                                        REPORTING CHECKLIST

                                                        • T Staging

                                                          • N Staging

                                                            • M Staging

                                                              Selected References

                                                              1. Chiang CL et al: Prognostic factors for overall survival in nasopharyngeal cancer and implication for TNM staging by UICC: a systematic review of the literature. Front Oncol. 11:703995, 2021
                                                              2. Li WZ et al: Assessment of survival model performance following inclusion of epstein-barr virus dna status in conventional tnm staging groups in epstein-barr Virus-Related Nasopharyngeal Carcinoma. JAMA Netw Open. 4(9):e2124721, 2021
                                                              3. Pan XB et al: Retropharyngeal lymph node metastasis on N stage of nasopharyngeal carcinoma. PLoS One. 16(6):e0253424, 2021
                                                              4. Cui C et al: Staging of T2 and T3 nasopharyngeal carcinoma: proposed modifications for improving the current AJCC staging system. Cancer Med. 9(20):7572-9, 2020
                                                              5. Glastonbury CM: Critical changes in the staging of head and neck cancer. Radiol Imaging Cancer. 2(1):e190022, 2020
                                                              6. Guo R et al: The evolution of nasopharyngeal carcinoma staging. Br J Radiol. 92(1102):20190244, 2019
                                                              7. Huang L et al: Prognostic value of retropharyngeal lymph node metastasis laterality in nasopharyngeal carcinoma and a proposed modification to the UICC/AJCC N staging system. Radiother Oncol. 140:90-7, 2019
                                                              8. King AD et al: Complementary roles of MRI and endoscopic examination in the early detection of nasopharyngeal carcinoma. Ann Oncol. 30(6):977-82, 2019
                                                              9. Ai QY et al: Staging nodal metastases in nasopharyngeal carcinoma: which method should be used to measure nodal dimension on MRI? Clin Radiol. 73(7):640-6, 2018
                                                              10. Chen YH et al: Value of early evaluation of treatment response using 18F-FDG PET/CT parameters and the Epstein-Barr virus DNA load for prediction of outcome in patients with primary nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging. 46(3): 650-60, 2018
                                                              11. Lee AW et al: International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma. Radiother Oncol. 126(1):25-36, 2018
                                                              12. Wu L et al: Nasopharyngeal carcinoma: a review of current updates. Exp Ther Med. 15(4):3687-92, 2018
                                                              13. Amin M.B. et al: AJCC Cancer Staging Manual. 8th Ed. Springer New York, 2017
                                                              14. Glastonbury CM et al: Setting the stage for 2018: how the changes in the American Joint Committee on Cancer/Union for International Cancer Control Cancer Staging Manual Eighth Edition impact radiologists. AJNR Am J Neuroradiol. 38(12):2231-7, 2017
                                                              15. Kang M et al: Validation of the 8th edition of the UICC/AJCC staging system for nasopharyngeal carcinoma treated with intensity-modulated radiotherapy. Oncotarget. 8(41):70586-94, 2017
                                                              16. Kang M et al: A new T staging system for nasopharyngeal carcinoma based on intensity-modulated radiation therapy: results from a prospective multicentric clinical study. Am J Cancer Res. 7(2):346-56, 2017
                                                              17. King AD et al: MR imaging criteria for the detection of nasopharyngeal carcinoma: discrimination of early-stage primary tumors from benign hyperplasia. AJNR Am J Neuroradiol. 39(3): 515-23, 2017
                                                              18. Naggar AK et al: Tumours of the nasopharynx. In WHO Classification of Head and Neck Tumours, 4th ed. Vol. 9. Lyon: International Agency for Research on Cancer. 63-76, 2017
                                                              19. Peng H et al: Significant value of 18F-FDG-PET/CT in diagnosing small cervical lymph node metastases in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy. Chin J Cancer. 36(1):95, 2017
                                                              20. Stelow EB et al: Update from the 4th edition of the World Health Organization classification of head and neck tumours: Nasopharynx. Head Neck Pathol. 11(1):16-22, 2017
                                                              21. Yan DF et al: The prognostic value of pretreatment tumor apparent diffusion coefficient values in nasopharyngeal carcinoma. BMC Cancer. 17(1):678, 2017
                                                              22. Fung SY et al: Clinical utility of circulating Epstein-Barr virus DNA analysis for the management of nasopharyngeal carcinoma. Chin Clin Oncol. 5(2):18, 2016
                                                              23. Wang HY et al: A new prognostic histopathologic classification of nasopharyngeal carcinoma. Chin J Cancer. 35:41, 2016
                                                              24. Zhang L et al: Plasma Epstein-Barr viral DNA complements TNM classification of nasopharyngeal carcinoma in the era of intensity-modulated radiotherapy. Oncotarget. 7(5):6221-30, 2016
                                                              25. Kamran SC et al: Nasopharyngeal carcinoma. Surg Oncol Clin N Am. 24(3):547-61, 2015
                                                              26. King AD et al: Detection of nasopharyngeal carcinoma by MR imaging: diagnostic accuracy of MRI compared with endoscopy and endoscopic biopsy based on long-term follow-Up. AJNR Am J Neuroradiol. 36(12):2380-5, 2015
                                                              27. Lan M et al: Prognostic value of cervical nodal necrosis in nasopharyngeal carcinoma: analysis of 1800 patients with positive cervical nodal metastasis at MR Imaging. Radiology. 276(2):536-44, 2015
                                                              28. Zhang W et al: The clinical utility of plasma Epstein-Barr virus DNA assays in nasopharyngeal carcinoma: the dawn of a new era?: a systematic review and meta-analysis of 7836 cases. Medicine (Baltimore). 94(20):e845, 2015
                                                              29. Shen G et al: Meta-analysis of diagnostic value of 18F-FDG PET or PET/CT for detecting lymph node and distant metastases in patients with nasopharyngeal carcinoma. Br J Radiol. 87(1044):20140296, 2014
                                                              30. Mosier KM: Skull base lesions: extracranial origins. Semin Ultrasound CT MR. 34(5):436-44, 2013
                                                              31. Abdel Khalek Abdel Razek A et al: MRI and CT of nasopharyngeal carcinoma. AJR Am J Roentgenol. 198(1):11-8, 2012
                                                              32. Ho FC et al: Patterns of regional lymph node metastasis of nasopharyngeal carcinoma: a meta-analysis of clinical evidence. BMC Cancer. 12:98, 2012
                                                              33. Li WF et al: Locoregional extension patterns of nasopharyngeal carcinoma and suggestions for clinical target volume delineation. Chin J Cancer. 31(12):579-87, 2012
                                                              34. King AD et al: Primary nasopharyngeal carcinoma: diagnostic accuracy of MR imaging versus that of endoscopy and endoscopic biopsy. Radiology. 258(2):531-7, 2011
                                                              35. King AD et al: Magnetic resonance imaging staging of nasopharyngeal carcinoma in the head and neck. World J Radiol. 2(5):159-65, 2010
                                                              36. Goh J et al: Imaging of nasopharyngeal carcinoma. Ann Acad Med Singapore. 38(9):809-16, 2009
                                                              37. Chong VF et al: Nasopharyngeal carcinoma. Eur J Radiol. 66(3):437-47, 2008
                                                              38. Ou SH et al: Epidemiology of nasopharyngeal carcinoma in the United States: improved survival of Chinese patients within the keratinizing squamous cell carcinoma histology. Ann Oncol. 18(1):29-35, 2007
                                                              39. Thompson LD: Update on nasopharyngeal carcinoma. Head Neck Pathol. 1(1):81-6, 2007
                                                              40. Wenig BM: Squamous cell carcinoma of the upper aerodigestive tract: precursors and problematic variants. Mod Pathol. 15(3):229-54, 2002
                                                              41. Chong VF et al: Carcinoma of the nasopharynx. Semin Ultrasound CT MR. 19(6):449-62, 1998