How is nasopharyngeal carcinoma clinically staged

How is nasopharyngeal carcinoma classified?

There are three types of spread of NPC:

1. Direct spread: The tumor can expand upward and invade and destroy the skull base bones, with the foramen ovale being the most common.

2. Lymphatic metastasis: The nasopharyngeal mucosa has abundant lymphatic vessels, so lymphatic metastasis can occur in the early stages of cancer. About half of nasopharyngeal cancer patients suffer from cervical lymphadenopathy.

3. Hematogenous metastasis: Cancer cells often metastasize to the liver, lungs, bones, followed by the kidneys, adrenal glands, and pancreas

Nasopharyngeal carcinoma is clinically staged appropriately based on whether the cancer cells have metastasized.

Ⅰ The primary cancer is confined to the nasopharynx, has not spread to the lymph nodes, and has no distant metastasis.

Ⅱ The primary lesion invades the nasal cavity and metastasizes to the lymph nodes not far away. The primary cancer is limited to the mobile or fixed lymph nodes in the upper cervical region of the nasopharynx, with a diameter of 3CM, and no distant metastasis.

Ⅲ The primary cancer invades the bone, paranasal sinuses or cranial nerves, without distant metastasis. There are movable or fixed lymph nodes in the upper neck with a diameter of 3CM. The primary lesion invades the nasal cavity, oropharynx or adjacent muscles and nerves below the skull base, without distant metastasis.

IV The primary lesion invades the nasal cavity, oropharynx, or adjacent muscles and nerves below the skull base. The primary cancer invades the bone, paranasal sinuses, or cranial nerves, or invades the hypopharyngeal cavity, orbit, or infratemporal fossa. Distant metastasis or skin or lymph nodes below the clavicle.

Ⅱ After combined chemotherapy and radiotherapy, the prognosis of nasopharyngeal carcinoma is generally good, and patients can easily accept the treatment. However, patients should pay attention to restraining their lifestyle after treatment and visit the hospital regularly for follow-up.