title: Current status of cancer care for young patients with nasopharyngeal carcinoma in Jakarta, Indonesia.
abstract: BACKGROUND
  Nasopharyngeal carcinoma (NPC) is endemic in Indonesia and 20% of the patients are diagnosed before the age of 31. This study evaluates presentation and treatment outcome of young patients in Jakarta, in a tertiary referral centre.
  
  
  METHODS
  Forty-nine patients under the age of 31, diagnosed with NPC between July 2004 and January 2007, were evaluated. Baseline data included histological type, stage of disease and presenting symptoms. We intended to follow all patients after diagnosis to reveal treatment outcome and overall survival (OS).
  
  
  RESULTS
  All but two patients had advanced stage disease (94%), 7 (14%) had distant metastasis. The median interval between start of complaints and diagnosis was 9 months. Forty-two patients were planned for curative intent treatment. Eleven patients (26%) never started treatment, 2 patients did not complete treatment and 3 patients did not return after finishing treatment. Four patients died before radiation could start. Three patients died within 4 months after treatment. Nine patients (21%) had a complete response. Due to the high number of patients who were lost to follow-up (LFU), OS was analyzed as follows: a best-case (patients censored at last contact) and a worst-case scenario (assuming that patients who did not finish treatment or had disease at last contact would have died). The 2-year OS for patients without distant metastases was 39-71%.
  
  
  CONCLUSIONS
  Treatment outcome for young patients with NPC in this institute was poor. Improvement can be achieved when NPC is diagnosed at an earlier stage and when there is better treatment compliance.
authors.affiliation: Ear, Nose and Throat, University of Indonesia, Dr. Cipto Mangunkusumo hospital, Jakarta, Indonesia.
authors.forename: Marlinda
authors.initials: M
authors.lastname: Adham
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Sharon D
authors.initials: SD
authors.lastname: Stoker
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Maarten A
authors.initials: MA
authors.lastname: Wildeman
authors.affiliation: Anatomy-Pathology, University of Indonesia, Dr. Cipto Mangunkusumo hospital, Jakarta, Indonesia.
authors.forename: Lisnawati
authors.initials: L
authors.lastname: Rachmadi
authors.affiliation: Radiotherapy, University of Indonesia, Dr. Cipto Mangunkusumo hospital, Jakarta, Indonesia.
authors.forename: Soehartati
authors.initials: S
authors.lastname: Gondhowiardjo
authors.affiliation: Haematology-Medical Oncology Internal Medicine, University of Indonesia, Dr. Cipto Mangunkusumo hospital, Jakarta, Indonesia.
authors.forename: Djumhana
authors.initials: D
authors.lastname: Atmakusumah
authors.affiliation: Medical Oncology Pediatric Department, University of Indonesia, Dr. Cipto Mangunkusumo hospital, Jakarta, Indonesia.
authors.forename: Djayadiman
authors.initials: D
authors.lastname: Gatot
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Renske
authors.initials: R
authors.lastname: Fles
authors.affiliation: Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Astrid E
authors.initials: AE
authors.lastname: Greijer
authors.affiliation: Ear, Nose and Throat, University of Indonesia, Dr. Cipto Mangunkusumo hospital, Jakarta, Indonesia.
authors.forename: Bambang
authors.initials: B
authors.lastname: Hermani
authors.affiliation: Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Jaap M
authors.initials: JM
authors.lastname: Middeldorp
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Ear, Nose and Throat Department, Gadjah Mada University, Yogyakarta, Indonesia; Department of Oral and Maxillofacial Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: I Bing
authors.initials: IB
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000328:Adult; D002277:Carcinoma; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007214:Indonesia; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D005791:Patient Care / Q000706:statistics & numerical data*; D016019:Survival Analysis; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult