Prognostic Scores of Neel et al for a Patient with Nasopharyngeal Carcinoma (NPC)

Parameters for TN score (based on T and N variables):

(1) extensive local disease that fills the nasopharynx

(2) direct regional tumor extension

(3) nerve involvement

(4) metastases to lymph nodes in lower neck or supraclavicular region

Parameters for total score (based on all 18 variables):

(1) age

(2) WHO type of carcinoma (Type 1 = squamous cell; Type 2 = nonkeratinizing; Type 3 = undifferentiated)

(3) extensive local disease that fills the nasopharynx

(4) metastases to lower lymph nodes

(5) number of symptoms (from Table 3: nasal bleeding, nasal obstruction, nasal pain, loss of smell, ears plugged, hearing loss, ear pain, tinnitus, choking, difficulty swallowing, voice change, throat pain, sensation of lump in throat, neck mass, neck pain, numbness, pain in face or head, weight loss, diplopia)

(6) titer of antibody in the ADCC (antibody-dependent cellular cytotoxicity) test

where:

• I do not know if the ADCC titer is available outside of a research setting.

• Lower lymph nodes refers to lower cervical or supraclavicular lymph nodes (see Table 4).

TN score =

= SUM(points for the 4 parameters)

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum TN and total score: 0

• maximum TN score: 4

• maximum total score: 6

• The higher the score the worse the prognosis.

• The presence of distant metastates was associated with poor prognosis (footnote Table 6).