NPCA (must knows) (both NCCN and Perez) (under construction)

Question 1

NPCA
AJCC Staging 2017

Identify the T Stage:

parapharyngeal space involvement

Answer 1

T2

Question 2

NPCA
AJCC Staging 2017

Identify the T Stage:

medial and lateral pterygoid “muscles” extension

Answer 2

T2

Question 3

NPCA
AJCC Staging 2017

Identify the T Stage:

prevertebral muscles involvement

Answer 3

T2

Question 4

NPCA
AJCC Staging 2017

Identify the T Stage:

hypopharyngeal involvement

Answer 4

T4

Question 5

NPCA
AJCC Staging 2017

Identify the T Stage:

infiltration of the bony structures of the skull base

Answer 5

T3

Question 6

NPCA
AJCC Staging 2017

Identify the T Stage:

involvement of pterygoid plates

Answer 6

T3

Question 7

NPCA
AJCC Staging 2017

Identify the T Stage:

involvement of paranasal siuses

Answer 7

T3

Question 8

NPCA
AJCC Staging 2017

Identify the T Stage:

extension to nasal cavity

Answer 8

T1

Question 9

NPCA
AJCC Staging 2017

Identify the T Stage:

oropharyngeal extension

Answer 9

T1

Question 10

NPCA
AJCC Staging 2017

Identify the T Stage:

no tumor identified but EBV+ cervical node+

Answer 10

T0

Question 11

NPCA
AJCC Staging 2017

Identify the N Stage:

solitary lymph node less 4 cm, level 4

Answer 11

N3

unilateral or bilateral metastasis in cervical lymph node(s),

larger than 6 cm,

and/or

“extension below the caudal border of the cricoid.”

Question 12

NPCA
AJCC Staging 2017

Identify the N Stage:

multiple bilateral retropharyngeal lymph nodes none larger than 6 cm.

Answer 12

N1

Unilateral metastasis in cervical nodes above the cricoid, none more than 6 cm,

and/or

“bilateral RPN”

Question 13

NPCA
AJCC Staging 2017

Identify the N Stage:

multiple bilateral lymph nodes at the level 2-3 cervical chains, none larger than 6 cm.

Answer 13

N2

bilateral above the cricoid, none more than 6

Question 14

NPCA
AJCC Staging

Identify the grade:

Well differentiated

Answer 14

NONE

Grading system is not used for NPCa.

Question 15

NPCA
AJCC Staging

Identify the Prognostic Group

T0, N2, M0

Answer 15

Stage III

T0-2 N1-2
or
T3 N0-2

Question 16

NPCA
AJCC Staging

Identify the Prognostic Group

T4, N0 M0

Answer 16

Stage IVA

Any T, N3
T4, N0-2

Question 17

NPCA
AJCC Staging

Identify the Prognostic Group

T1, N0, M0

Answer 17

Stage I

T1 N0

Question 18

NPCA
AJCC Staging

Identify the Prognostic Group

T2, N1, M0

Answer 18

Stage II

T0-1, N0-1
T2, N0-1

Question 19

NPCA

What is the preferred treatment for Stage I disease?

Answer 19

RT alone

Question 20

NPCA

What is the preferred treatment for Stage II-IVA disease?

Answer 20

induction chemo + CCRT
or
CCRT + adjv. chemo

CCRT alone is category 2B

Question 21

NPCA

What is the preferred chemotherapy regimen for CCRT?

Answer 21

cisplatin

Question 22

NPCA

What is the preferred drug combination for induction therapy?

Answer 22

Cisplatin+Gemcitabine
(cat1)

TPF (cat1 only for non-EBV associated)

Question 23

NPCA

What is the preferred drug combination for adjuvant therapy?

Answer 23

PF

Question 24

NPCA

Where is the most common origin of NPCA?

Answer 24

lateral walls (incl. fossa of Rosenmüller)

Question 25

NPCA

Boundaries of the nasopharynx.
Anterior

Answer 25

continuous with the nasal cavity, via the posterior choanae

Question 26

NPCA

Boundaries of the nasopharynx.
inferior

Answer 26

communicates with the oropharynx

Question 27

NPCA

Boundaries of the nasopharynx.
Roof

Answer 27

basilar portion of sphenoid and occipital bones

Question 28

NPCA

Boundaries of the nasopharynx.
Floor

Answer 28

superior surface of the soft palata and nasopharyngeal isthmus

Question 29

NPCA

Boundaries of the nasopharynx.
lateral walls

Answer 29

Eustachian tube bounded by the torus tubarius

Question 30

NPCA

Boundaries of the nasopharynx.
contents of the posterior wall

Answer 30

pharyngeal constrictors
pharyngobasilar fascia
buccopharyngeal fascia