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, CPG Management of Nasopharyngeal Carcinoma 2016Published by:
Malaysia Health Technology Assessment Section (MaHTAS)
Medical Development Division, Ministry of Health Malaysia
Level 4, Block E1, Precinct 1
Federal Government Administrative Centre
62590, Putrajaya, Malaysia
Copyright
The copyright owner of this publication is MaHTAS. Content may be
reproduced in any number of copies and in any format or medium
provided that a copyright acknowledgement to MaHTAS is included and
the content is not changed, not sold, nor used to promote or endorse
any product or service, and not used in an inappropriate or misleading
context.
ISBN: 978-967-0769-73-8
Available on the following websites:
http://www.moh.gov.my
http://www.acadmed.org.my
http://www.msohns.com
Also available as an app for Android and IOS platform: MyMaHTAS
, CPG Management of Nasopharyngeal Carcinoma 2016
STATEMENT OF INTENT
These clinical practice guidelines (CPG) are meant to be guides for
clinical practice, based on the best available evidence at the time of
development. Adherence to these guidelines may not necessarily
guarantee the best outcome in every case. Every healthcare provider is
responsible for the management of his/her unique patient based on the
clinical picture presented by the patient and the management options
available locally.
These guidelines were issued in 2016 and will be reviewed in 2020 or
sooner if new evidence becomes available. When it is due for updating,
the Chairman of the CPG or National Advisor of the related specialty
will be informed about it. A discussion will be done on the need for
a revision including the scope of the revised CPG. A multidisciplinary
team will be formed and the latest systematic review methodology used
by MaHTAS will be employed.
Every care is taken to ensure that this publication is correct in every
detail at the time of publication. However, in the event of errors or
omissions, corrections will be published in the web version of this
document, which is the definitive version at all times. This version can
be found on the websites mentioned above.
, CPG Management of Nasopharyngeal Carcinoma 2016
KEY RECOMMENDATIONS
The following recommendations were highlighted by the guidelines
Development Group as the key clinical recommendations that should
be prioritise for implementation.
Clinical Presentations and Referral
Recommendation 1
• Patients presenting with any of the following symptoms should be
referred to Otorhinolaryngologists as soon as possible to rule out
nasopharyngeal carcinoma :
painless neck lump (unilateral/bilateral)
blood-stained nasal discharge/saliva
unilateral ear block or hearing loss
headache
facial numbness
diplopia
Investigations
Recommendation 2
• Nasopharyngoscopy should be performed in all patients suspected
of nasopharyngeal carcinoma (NPC).
• NPC should be diagnosed by histopathological examination of the
nasopharynx.
• In patients presenting with cervical lymphadenopathy, full head and
neck assessment and fine needle aspiration cytological examination
of the nodes should be done.
Staging
Recommendation 3
• All nasopharyngeal carcinoma patients should be staged using the
tumour node metastasis (TNM) system.
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