Nasopharyngectomy for recurrent nasopharyngeal carcinoma: A review of 53 patients and prognostic factors

Sheng Po Hao*, Ngan Ming Tsang, Kai Ping Chang, Yung Shin Hsu, Chin Kuo Chen, Ku Hao Fang

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

67 Scopus citations

Abstract

Conclusions. Salvage surgery is a justified treatment for primary recurrence of nasopharyngeal carcinoma (NPC). Skull base surgery can play a role in rescuing patients with more advanced local recurrence of NPC. Objectives. The purpose of this study was to report the local control and overall survival outcome of patients with (NPC) with local failure who received salvage nasopharyngectomy and to identify prognostic factors. Patients and methods. Fifty-three consecutive patients who had primary recurrence of NPC and underwent salvage surgery with curative intention from July 1993 to December 2006 were retrospectively reviewed. The follow-up time ranged from 5.1 to 142.2 months. The numbers of cases of recurrent NPC stage were as follows: stage I, 26; stage II, 9; stage III, 10 and stage IV, 8. Fifty patients had one course of radiation therapy while 3 had two courses of radiation therapy before the salvage surgery. For the nasopharyngectomy, 2 patients underwent endoscopic approach and 33 underwent facial translocation, while 18 had craniofacial resection. Postoperative adjuvant treatment included radiation therapy, 4 cases; radiosurgery, 8 cases; concurrent chemoradiation therapy, 7 cases; and chemotherapy, 2 cases. Results. The 5-year local control rates were T1, 58.3%; T2, 27.8%; T3, 53.3%; T4, 75.0%; and all stages, 53.6%. The 5-year overall survival rates were stage I, 64.8%; stage II, 38.1%; stage III, 25.9%; stage IV, 46.9%; and all stages, 48.7%. Multivariate analysis revealed that gender, margin status, adjuvant treatment type and parapharyngeal space involvement were significant impact factors of local control, whereas dura or brain involvement, local recurrence and adjuvant treatment type were significant impact factors of survival.

Original languageEnglish
Pages (from-to)473-481
Number of pages9
JournalActa Oto-Laryngologica
Volume128
Issue number4
DOIs
StatePublished - 2008

Keywords

  • Local control
  • Nasopharyngeal carcinoma
  • Nasopharyngectomy
  • Prognostic factors
  • Salvage surgery
  • Survival

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