title: Nasopharyngectomy and surgical margin status: a survival analysis.
abstract: OBJECTIVE
  To explore whether the margin status at surgical salvage nasopharyngectomy for local residual or recurrent nasopharyngeal carcinoma affects patient survival.
  
  
  METHODS
  Retrospective case series review.
  
  
  METHODS
  Academic tertiary referral center.
  
  
  METHODS
  Seventy-nine consecutive patients with operable local residual or recurrent nasopharyngeal carcinoma after failure of primary treatment with radiotherapy with or without chemotherapy underwent surgical salvage nasopharyngectomy with curative intent between November 28, 1987, and November 17, 2003. Sixty-one patients were men and 18 were women. Their mean age was 48 years (age range, 26-70 years).
  
  
  METHODS
  Surgical salvage nasopharyngectomy.
  
  
  METHODS
  The status of the closest margin at surgery was assessed as clear, close, or positive. Survival time was measured from the date of surgery to the date of the last follow-up, to the date of an event occurrence, or to the date of death. The Kaplan-Meier method was used to estimate the probability of local progression-free survival and overall survival at 5 years. Differences in survival rates between surgical margin statuses were assessed using the log-rank test.
  
  
  RESULTS
  Five-year overall survival for patients with clear margins was 77%, for patients with close margins was 46% (P = .05), and for patients with positive margins was 23% (P < .001).
  
  
  CONCLUSIONS
  Clear surgical margins at the time of surgical salvage nasopharyngectomy for residual or recurrent nasopharyngeal carcinoma positively affect patient survival.
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong. lexvlantis@cuhk.edu.hk
authors: Alexander C
authors: AC
authors: Vlantis
authors: Raymond K Y
authors: RK
authors: Tsang
authors: Brian K H
authors: BK
authors: Yu
authors: Michael K M
authors: MK
authors: Kam
authors: Michael C F
authors: MC
authors: Tong
authors: Phoebe S Y
authors: PS
authors: Lo
authors: C Andrew
authors: CA
authors: van Hasselt
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000401:mortality* / Q000601:surgery; D009666:Nose / Q000601:surgery*; D010611:Pharyngectomy / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome