Epidemiologic and clinicopathologic characteristics of nasopharyngeal carcinoma at a tertiary care center in Saudi Arabia.

Background: Nasopharyngeal carcinoma (NPC) is rare globally; however, in Saudi Arabia, it is the most common head and neck cancer and the 17th most common cancer overall. This study aimed to describe the epidemiological characteristics, clinical features, and histopathological subtypes of NPC in patients at a tertiary care center in Saudi Arabia. Methods: This retrospective cohort study included 244 patients with histologically confirmed nasopharyngeal carcinoma (NPC) managed at a tertiary referral hospital between January 2014 and June 2024. Demographic characteristics, clinical presentation, risk factors, histopathology, Epstein-Barr virus (EBV) status, and treatment modalities were extracted from medical records and analyzed using SPSS version 23. Results: Among the 244 patients, 75% were male and 25% were female, with the most affected age groups being 50-64 years (39%), followed by those aged ≥65 years (30%). neck mass was the most common presenting symptom (31%). Histopathologically, undifferentiated carcinoma (WHO Type III) was predominant (77%). Most patients were diagnosed at an advanced stage, with 20% at stage III and 56% at stage IV. Smoking, EBV infection, and demographics showed no significant association with any histopathological subtype. Concurrent chemoradiotherapy (CCRT) was the most common treatment modality (37%) followed by induction chemotherapy with CCRT (31%). Conclusion: In Saudi Arabia, NPC predominantly affects older males, with neck masses being the most frequent symptom. Smoking and EBV infection showed no significant association with histopathological subtypes. Most cases were undifferentiated carcinomas (WHO Type III) and diagnosed at advanced stages, highlighting the need for continued surveillance and multicenter studies in Saudi Arabia.