Chinese Journal of Cancerindexed by SCI
《癌症》杂志
BMC

doi: 10.5732/cjc.011.10328
Nasopharyngeal carcinoma in Indonesia: epidemiology, incidence,signs, and symptoms at presentation
Marlinda Adham, Antonius N. Kurniawan, Arina Ika Muhtadi, Averdi Roezin, Bambang Hermani, Soehartati Gondhowiardjo, I Bing Tan, Jaap M. Middeldorp
Department of Otorhinolaryngology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
[Abstract] Among all head and neck (H&N) cancers, nasopharyngeal carcinoma (NPC) represents a distinct entity regarding epidemiology, clinical presentation, biological markers, carcinogenic risk factors, and prognostic factors. NPC is endemic in certain regions of the world, especially in Southeast Asia, and has a poor prognosis. In Indonesia, the recorded mean prevalence is 6.2/100 000, with 13 000 yearly new NPC cases, but otherwise little is documented on NPC in Indonesia. Here, we report on a group of 1121 NPC patients diagnosed and treated at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia between 1996 and 2005. We studied NPC incidence among all H&N cancer cases (n=6000) observed in that period, focusing on age and gender distribution, the ethnic background of patients, and the disease etiology. We also analyzed most prevalent signs and symptoms and staging of NPC patients at first presentation. In this study population, NPC was the most frequent H&N cancer (28.4%), with a male-to-female ratio of 2.4, and was endemic in the Javanese population. Interestingly, NPC appeared to affect patients at a relatively young age (20% juvenile cases) without a bimodal age distribution. Mostly, NPC initiated in the fossa of Rosenmuller and spreaded intracranially or locally as a mass in the head. Occasionally, NPC developed at the submucosal level spreading outside the anatomic limits of the nasopharynx. At presentation, NPC associated with hearing problems, serous otitis media, tinnitus, nasal obstruction, anosmia, bleeding, difficulty in swallowing and dysphonia, and even eye symptoms with diplopia and pain. The initial diagnosis is difficult to make because early signs and symptoms of NPC are not specific to the disease. Early-age Epstein-Barr virus (EBV) infection combined with frequent exposure to environmental carcinogenic co-factors is suggested to cause NPC development. Undifferentiated NPC is the most frequent histological type and is closely associated with EBV. Expression of the EBV-encoded latent membrane protein 1(LMP1) oncogene in biopsy material was compared between NPC patients of <30 years old and those of ⩾30 years old, matched for sex and tumor stage. Higher LMP1 expression in patients of <30 years old was observed, which was related to more locoregional progressivity. Increased medical awareness of prevailing early stage signs and symptoms coupled to use of EBV-related diagnostic tumor markers may lead to down-staging and timely treatment to improve survival of patients with this aggressive disease.
Chinese Journal of Cancer 2012, Volume: 31, Issue 4, Page: 185-196
[ PDF Full-text ]
[ Html full-text ](PubMed Central)

[ PubMed ]

[Google Scholar]


Cite this article

Marlinda Adham, Antonius N. Kurniawan, Arina Ika Muhtadi, Averdi Roezin, Bambang Hermani, Soehartati Gondhowiardjo, I Bing Tan, Jaap M. Middeldorp. Nasopharyngeal carcinoma in Indonesia: epidemiology, incidence,signs, and symptoms at presentation. Chin J Cancer. 2012, 31(4):185-196. doi:10.5732/cjc.011.10328


Export citations

EndNote


SHARE THIS ARTICLE


Your Comments

  

 


Comments:


CJC Wechat 微信公众号

CJC触屏版


 

Editorial Manager


CJC adopts Editorial Manager to manage its submissions from Dec.18, 2014
 

 

Reference style for  

 EndNote,
 Reference Manager



Editorial Manager


 

Year:

 

Month:

Advanced search

Subscription


CJC is now published by BioMed Central

© Chinese Journal of Cancer

Sun Yat-sen University Cancer Center

651 Dongfeng Road East, Guangzhou 510060, P. R. China