Nasopharyngeal carcinoma: Treatment Pattern and Survival in Addis Ababa, Ethiopia.

Purpose: Nasopharyngeal cancer (NPC) is the most commonly diagnosed head and neck cancers seen at Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. However, data on treatment patterns, survival, and prognostic factors of NPC are limited in the country.

Methodology: A retrospective study of 136 histopathologically proven NPC patients seen at the TASH Oncology Department from 09/15/2014 to 09/10/2017 and followed for vital status through 10/31/2020. Descriptive statistics were calculated and chi-square tests were performed using SPSS version 26. Survival curves were analyzed using the Kaplan-Meier method, and survival curves between groups of patients were compared using a log-rank test. A multivariable Cox proportional hazard model was used to identify prognostic factors. P< 0.05 was used for all analyses.

Results: A majority of NPC patients (83.3%) presented with stage III-IV diseases, and nearly a quarter (23.5%) of the patients did not receive any form of treatment. The median waiting time from the date of presentation at TASH to receipt of any form of treatment was 3.2 months. In the multivariable analysis, survival was statistically significantly associated with older age, male sex, residing outside of Addis Ababa, having headache symptoms longer duration of symptoms, advanced stage at diagnosis, longer waiting time to initiation of treatment, and lack of follow up.

Conclusions: Nearly a quarter of NPC patients seen at TASH did not receive cancer-directed treatment and the waiting period for initiation of treatment was long, which was associated with poor survival. The findings reinforce the importance of strengthening the healthcare infrastructure to improve the quality of care for NPC patients in Ethiopia.

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