title: Salvage surgery for recurrent nasopharyngeal carcinoma.
abstract: OBJECTIVE
  To assess the efficacy of salvage surgery for patients with recurrent nasopharyngeal carcinoma (NPC) at the primary site after radiotherapy.
  
  
  METHODS
  Retrospective analysis of 24 patients treated by transpalatal, transmaxillary, or transmandibular approach to resect the recurrent tumor, with maximum follow-up of 50 months.
  
  
  METHODS
  Academic tertiary referral center.
  
  
  RESULTS
  Radiotherapy before salvage surgery included 1 to 3 courses of radiation to the nasopharynx, with doses ranging from 60 to 190 Gy. Eighteen (75%) of the patients relapsed within 2 years, and 6 (25%) relapsed more than 6 years after the last irradiation. In 4 of 6 late-relapsing cases, the histopathological type changed to keratinizing squamous cell carcinoma, which is rare in cases of NPC in Taiwan. Fourteen patients (58%) survived for 8 to 50 months after surgery (median, 18 months). The surgical complications were tolerable.
  
  
  CONCLUSIONS
  Salvage surgery is feasible in selected patients with recurrent disease at the primary site. Thus, we can offer alternative retreatment in addition to external irradiation for patients with recurrent NPC.
authors.affiliation: Department of Otolaryngology, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan. mmhsu@ntumc1.mc.ntu.edu.tw
authors.forename: M M
authors.initials: MM
authors.lastname: Hsu
authors.forename: J Y
authors.initials: JY
authors.lastname: Ko
authors.forename: T S
authors.initials: TS
authors.lastname: Sheen
authors.forename: Y L
authors.initials: YL
authors.lastname: Chang
mesh_terms: D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D009305:Nasopharynx / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016879:Salvage Therapy; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors