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


OBJECTIVE
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.


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.
Hao
Sheng-Po
SP
Department of Otolaryngology Head & Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan. shengpo@adm.cgmh.org.tw
Tsang
Ngan-Ming
NM
Chang
Kai-Ping
KP
Hsu
Yung-Shin
YS
Chen
Chin-Kuo
CK
Fang
Ku-Hao
KH
D000328:Adult; D000368:Aged; D001706:Biopsy; D002277:Carcinoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D009367:Neoplasm Staging; D010611:Pharyngectomy / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed