Salvage surgery for locally recurrent nasopharyngeal carcinoma-A 10-year experience.
OBJECTIVE
To evaluate the result of salvage surgery for patients with primary recurrence of nasopharyngeal carcinoma (NPC) after radiation therapy.


METHODS
Prospective cohort at a tertiary referral center.


METHODS
Thirty-eight consecutive patients with primary recurrence of NPC after radiation failure underwent salvage surgery for curative intention via the facial translocation approach from July 1993 to December 2002. The follow-up time ranged from 2 to 88 months. Twelve patients with intracranial and skull base invasion needed a combined neurosurgical approach. Eight patients had additional postoperative radiation therapy.


RESULTS
The actuarial 3-year survival and local control rate was 60% and 72.8%, respectively. Ten (83.3%) of 12 patients with intracranial and skull base invasion achieved local control. There was no surgical mortality, and the morbidity rate was only 13.2%.


CONCLUSIONS
The results of this study reveal better outcome of salvage surgery than that of most published literature of reirradiation for recurrent NPC. With the adequate exposure provided by the facial translocation approach, an integrated concept of skull base surgery, and the collaboration of neurosurgeons, we can extend our surgical indications of salvage surgery and resect many advanced lesions with acceptable mortality and morbidity.
Chang
Kai-Ping
KP
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Cancer Center, Graduate Institute of Clinical Medical Sciences, Chang Gung Memorial Hospital and Chang Gung University, Taiwan, Republic of China.
Hao
Sheng-Po
SP
Tsang
Ngan-Ming
NM
Ueng
Shir-Hwa
SH
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D016879:Salvage Therapy; D015996:Survival Rate