METHODS: One hundred and thirty four NPC cases confirmed by histopathology in Hospital USM between 1st January 1998 and 31st December 2007 that fulfilled the inclusion and exclusion criteria were retrospectively reviewed. Survival time of NPC patients were estimated by Kaplan-Meier survival analysis. Log-rank tests were performed to compare survival of cases among presenting symptoms, WHO type, TNM classification and treatment modalities.
RESULTS: The overall five-year survival rate of NPC patients was 38.0% (95% confidence interval (CI): 29.1, 46.9). The overall median survival time of NPC patients was 31.30 months (95%CI: 23.76, 38.84). The significant factors that altered the survival rate and time were age (p=0.041), cranial nerve involvement (p=0.012), stage (p=0.002), metastases (p=0.008) and treatment (p<0.001).
CONCLUSION: The median survival of NPC patients is significantly longer for age≤50 years, no cranial nerve involvement, and early stage and is dependent on treatment modalities.
Case Report: This report describes a rare case of metastatic adenocarcinoma of the temporal bone causing Collet-Sicard syndrome, presenting with hearing loss, headache and ipsilateral cranial nerve palsies. The patient was a 68-year old woman initially diagnosed with extensive mastoiditis and later confirmed as having metastatic adenocarcinoma of the temporal bone, based on histopathologic findings.
Conclusion: Clinical presentation of metastatic carcinoma of the temporal bone can be overshadowed by infective or inflammatory conditions. This case report is to emphasize the point that a high index of clinical suspicion is necessary for the early diagnosis of this aggressive disease which carries relatively poor prognosis. This report highlights that it is crucial to suspect malignant neoplasm in patients with hearing loss, headache and cranial nerve palsies.