Nasopharyngeal cancer (NPC) is a unique disease that shows clinical behaviour, epidemiology and histopathology that is different from that of other squamous cell carcinomas of the head and neck. Magnetic resonance imaging (MRI) is now the preferred imaging modality in the assessment and staging of NPC, especially in relation to its superior soft tissue contrast, ability to demonstrate perineural tumour spread, parapharyngeal space, bone marrow involvement and its ability to show the involvement of adjacent structures, such as the adjacent paranasal sinuses and intracranial extension. An understanding of its patterns of spread and the criteria used in the AJCC TNM staging system is important to relay the relevant information to the referring clinician, so that appropriate treatment planning decisions may be made. In this article, the various features of NPC that are pertinent to staging and treatment planning will be discussed, inclusive of locoregional spread, nodal involvement and metastatic disease.
Nasopharyngeal cancer (NPC) is considered an Asian disease, particularly in the southern Chinese population; the incidence in Guangzhou is quoted to be up to 800 cases per million people.1 It is rare in the rest of the world, although NPC has spread to other areas of the world due to immigration. Intermediate rates are recorded in areas such as Southeast Asia, Hong Kong, Taiwan and locations with large numbers of immigrant Chinese such as San Francisco and New York. A high incidence in non-Chinese populations has also been found, such as the indigenous Bidayuh people of Sarawak.
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