RADIOLOGICAL PATTERNS OF HEAD AND NECK CANCERS IN KARACHI: A CLINICAL AUDIT

Abstract

Background: Head and neck cancers are one of the most common malignancies worldwide. The purpose of this study was multislice CT scan based demographic and radiological audit of head and neck cancers in Pakistani population. Methods: This was a retrospective study of all head and neck cancer cases that presented to the Karachi X-Rays and Diagnostic Center, Karachi from 01^st June 2009 till 31^st May 2010. The scans were performed using a 16 slice Toshiba Activion. Results: A total of 511 patients were recorded during the study period study  [342 (67%) males :169 (33%) females]. Mean age was 52 years. The most common site of the head and neck tumors was the oral cavity [353 (69%)] followed by larynx [158 (31%)]. In order of frequency, the most common oral cavity cancers were buccal mucosa (37%), tongue (17%), alveolus (09%) and lip ( 06%).  Of the oral cavity lesions, buccal mucosa accounted for (53%), tongue (29.6%), alveolus (13%) and lip accounted for (8.6%) patients. Most patients presented with tumor stage T3. The most common nodal stage was N2b. Lung metastases were present in 87 (17%). Contralateral nodes were present in 301 (59%) patients and absent in 209 (41%). Conclusion: Head and neck malignancies are common in Pakistan. CT scan plays a significant role in the diagnosis and staging. A male predominance was noted especially for laryngeal cancers. Buccal mucosa was the commonest site in oral cancers. Presentation was found to be significantly delayed and most patients presented at an advanced stage when compared to earlier reports. We recommend a centralized data registry, public awareness campaign, and screening programs for prevention, earlier diagnosis and better treatment outcomes in Pakistani population.

 Key words: head and neck cancers; buccal cavity; larynx; multislice CT; Karachi