Skenario

Laki-laki 55 tahun, datang ke poli THT dengan keluhan benjolan pada leher, semakin lama semakin
membesar sejak 2 bulan yang lalu. Keluhan disertai sulit bernapas, keluar darah dari hidung, dan telinga
terasa penuh selama seminggu terakhir . Pasien juga merasa nyeri pada daerah wajah seperti ditusuk-
tusuk setiap kali mengunyah. Pasien mengaku sebagai perokok sejak 2 tahun yang lalu. Dari hasil
pemeriksaan fisik leher didapatkan pembesaran kelenjar getah bening unilateral, ukuran 5 cm diatas
fossa supra clavicula, batas difus, permukaan berbenjol, konsistensi keras, terfiksir. Dari hasil
pemeriksaan, dokter menduga penyakit pasien carcinoma nasofaring. Selanjutnya dilakukan biopsy dan
hasilnya menunjukan carcinoma nasofaring stadium IV A. Lalu pasien bertanya apakah kebiasaan
merokoknya bisa memperparah penyakitnya atau tidak.

P = Pasien dengan Carcinoma Nasofaring Stadium IV A

I = Merokok

C = Tidak merokok

O = Survival rate

Keyword = ((Carcinoma nasopharyngeal) AND Smoking) AND Prognostic

Background question =

 Apakah yang dimaksud Carcinoma Nasofaring?

 Bagaimana mendiagnosis Carcinoma Nasofaring?

Foreground question =

Bagaimana prognosis Carcinoma nasofaring pada perokok ?

Hasil =
1. Outcomes and Prognostic Factors of Radiation-Induced and De Novo Head and Neck
Squamous Cell Carcinomas.
Tay GC, Iyer NG, Ong WS, Tai D, Ang MK, Ha TC, Soo KC, Tan HK.
Otolaryngol Head Neck Surg. 2016 Mar 8. pii: 0194599816631726. [Epub ahead of print]
PMID: 26956200
2. Cigarette smoking complements the prognostic value of baseline plasma Epstein-Barr
virus deoxyribonucleic acid in patients with nasopharyngeal carcinoma undergoing
intensity-modulated radiation therapy: a large-scale retrospective cohort study.
Lv JW, Chen YP, Zhou GQ, Tang LL, Mao YP, Li WF, Guo R, Lin AH, Ma J, Sun Y.
Oncotarget. 2016 Feb 23. doi: 10.18632/oncotarget.7609. [Epub ahead of print]
PMID: 26919237
3. The effects of hemoglobin levels and their interactions with cigarette smoking on
survival innasopharyngeal carcinoma patients.
Zeng Q, Shen LJ, Li S, Chen L, Guo X, Qian CN, Wu PH.
 Cancer Med. 2016 Jan 28. doi: 10.1002/cam4.647. [Epub ahead of print]
PMID: 26817420
4. Pretreatment anemia and survival in nasopharyngeal carcinoma.
Zhang LN, Tang J, Lan XW, OuYang PY, Xie FY.
Tumour Biol. 2015 Sep 10. [Epub ahead of print]
PMID: 26358251
5. Survival and Prognostic Analysis of Primary Nasopharyngeal Carcinoma in North
China.
Qu Y, Chen Y, Yu H, Zhao Y, Chen G, Bai L, Liu D, Su H, Wang H.
Clin Lab. 2015;61(7):699-708.
PMID: 26299068
6. Ten-year outcomes of a randomised trial for locoregionally
advanced nasopharyngeal carcinoma: A single-institution experience from an endemic
area.
Huang PY, Zeng Q, Cao KJ, Guo X, Guo L, Mo HY, Wu PH, Qian CN, Mai HQ, Hong
MH.
Eur J Cancer. 2015 Sep;51(13):1760-70. doi: 10.1016/j.ejca.2015.05.025. Epub 2015 Jun 17.
PMID: 26093812
7. Elevated high-sensitivity C-reactive protein levels predict decreased survival
for nasopharyngealcarcinoma patients in the intensity-modulated radiotherapy era.
Tang LQ, Hu DP, Chen QY, Zhang L, Lai XP, He Y, Xu YX, Wen SH, Peng YT, Chen
WH, Guo SS, Liu LT, Qian CN, Guo X, Zeng MS, Mai HQ.
PLoS One. 2015 Apr 13;10(4):e0122965. doi: 10.1371/journal.pone.0122965. eCollection 2015.
PMID: 25874450
8. Prognoses and long-term outcomes of nasopharyngeal carcinoma in Han and Uyghur
patients treated with intensity-modulated radiotherapy in the Xinjiang Autonomous
Region of China.
Wang R, Tan Y, Wang X, Ma L, Wang D, Hu Y, Qin Y, Liu K, Chang C, Yu J.
PLoS One. 2014 Nov 6;9(11):e111145. doi: 10.1371/journal.pone.0111145. eCollection 2014.
PMID: 25375129
9. Hotspot mutations in common oncogenes are infrequent
in nasopharyngeal carcinoma.
Jiang N, Liu N, Yang F, Zhou Q, Cui R, Jiang W, He Q, Li W, Guo Y, Zeng J, Yun J,
Chen X, Zhou B, Sun Y, Wang H, Chen ZG, Ma J.
Oncol Rep. 2014 Oct;32(4):1661-9. doi: 10.3892/or.2014.3376. Epub 2014 Aug 1.
PMID: 25109408
10. Clinical and prognostic analysis of second primary squamous cell carcinoma of the
tongue after radiotherapy for nasopharyngeal carcinoma.
Sun C, Hu Z, Zhong Z, Jiang Y, Sun R, Fei J, Xi Y, Li X, Song M, Li W, Li Q.
Br J Oral Maxillofac Surg. 2014 Oct;52(8):715-20. doi: 10.1016/j.bjoms.2014.06.015. Epub 2014 Jul 30.
PMID: 25085271
11. Serglycin expression: An independent marker of distant metastases
in nasopharyngealcarcinoma.
Chia CS, Ong WS, Li XJ, Soong YL, Chong FT, Tan HK, Soo KC, Qian CN, Teh BT, Iyer
NG.
Head Neck. 2016 Jan;38(1):21-8. doi: 10.1002/hed.23841. Epub 2015 Jan 27.
PMID: 24995621
12. Nonendemic HPV-positive nasopharyngeal carcinoma: association with poor
prognosis.
Stenmark MH, McHugh JB, Schipper M, Walline HM, Komarck C, Feng FY, Worden FP,
Wolf GT, Chepeha DB, Prince ME, Bradford CR, Mukherji SK, Eisbruch A, Carey TE.
Int J Radiat Oncol Biol Phys. 2014 Mar 1;88(3):580-8. doi: 10.1016/j.ijrobp.2013.11.246.
PMID: 24521676
13. Prognostic impact of cigarette smoking on the survival of patients with
establishednasopharyngeal carcinoma.
Ouyang PY, Su Z, Mao YP, Liang XX, Liu Q, Deng W, Xie FY.
Cancer Epidemiol Biomarkers Prev. 2013 Dec;22(12):2285-94. doi: 10.1158/1055-9965.EPI-13-0546. Epub
2013 Nov 19.
PMID: 24252872
14. Association between single nucleotide polymorphisms in the p53 pathway and response
to radiotherapy in patients with nasopharyngeal carcinoma.
Xie X, Jin H, Hu J, Zeng Y, Zhou J, Ouyang S, Yang W, Hu B, Wang H.
Oncol Rep. 2014 Jan;31(1):223-31. doi: 10.3892/or.2013.2808. Epub 2013 Oct 24.
PMID: 24173110
15. Prognostic value of ABO blood group in southern Chinese patients with
establishednasopharyngeal carcinoma.
Ouyang PY, Su Z, Mao YP, Liu Q, Xie FY.
Br J Cancer. 2013 Oct 29;109(9):2462-6. doi: 10.1038/bjc.2013.559. Epub 2013 Sep 10.
PMID: 24022193
16. Smoking is a poor prognostic factor for male nasopharyngeal carcinoma treated with
radiotherapy.
Chen C, Shen LJ, Li BF, Gao J, Xia YF.
Radiother Oncol. 2014 Mar;110(3):409-15. doi: 10.1016/j.radonc.2013.08.003. Epub 2013 Sep 7.
PMID: 24021341
17. Comorbidity and prognosis in head and neck cancers: Differences by subsite, stage, and
human papillomavirus status.
Habbous S, Harland LT, La Delfa A, Fadhel E, Xu W, Liu FF, Goldstein D, Waldron J,
Huang SH, O'Sullivan B, Liu G.
Head Neck. 2014 Jun;36(6):802-10. doi: 10.1002/hed.23360. Epub 2013 Jul 30.
PMID: 23616414
18. Pretreatment lifestyle behaviors as survival predictors for patients
with nasopharyngealcarcinoma.
Shen GP, Xu FH, He F, Ruan HL, Cui C, Chen LZ, Zeng YX, Jia WH.
PLoS One. 2012;7(5):e36515. doi: 10.1371/journal.pone.0036515. Epub 2012 May 8.
PMID: 22590554