Clinical features of pharyngeal cancer: a retrospective study of 258 consecutive patients

Pharyngeal cancer still presents an unsatisfactory mortality (30-40 per cen t in most series, with a slightly better prognosis for nasopharyngeal cance r relative to both oropharyngeal and hypophyarngeal cancers) despite advanc es in treatment. Therefore, it is critical to know the clinical features of pharyngeal cancer. The purpose of this study was to investigate the most r elevant clinical features of pharyngeal cancer (oropharyngeal, hypopharynge al, and nasopharyngeal) in order to improve knowledge of this malignancy wi th the aim of ameliorating diagnosis and treatment. The retrospective study was based on a review of medical records from 258 c onsecutive patients with pharyngeal cancer (oropharyngeal, hypopharyngeal a nd nasopharyngeal) diagnosed at La Pat University Hospital, Madrid, Spain, between January 1 1991 and and December 31 1995. Medical records were provi ded by the Departments of Otorhinolaryngology, Head and Neck Surgery, Radia tion Oncology, and Medical Oncology. All medical records were analysed for the following clinical variables: 1) incidence, 2) sociodemographics, 3) sites (oropharynx, hypopharynx, nasopha rynx) and subsites, 4) clinical and histological staging, 5) pathlogy, 6) p resenting symptoms, 7) time to diagnosis, 8) patients' general performance status at diagnosis, 9) personal cancer history and synchronous head and ne ck tumours, 10) premalignant lesions, and 11) paediatric cases. Our most outstanding finding was the excessively long time that elapsed bet ween first clinical manifestation appearance and conclusive diagnosis of ph aryngeal cancer (4.7 months for pharynx, 4.5 for oropharynx, 4.4 for hypoph arynx and 6.5 for nasopharynx cancers). It was found that nasopharyngeal ca ncer was quite different from both oropharyngeal and hypopharyngeal cancers with respect to its potential aetiology, risk factors and clinical present ation. In addition it has a better prognosis.