title: Surgical salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma: a multivariate analysis of prognostic factors.
abstract: BACKGROUND
  The purpose of this study was to identify independent prognostic factors that influenced local relapse-free survival (LRFS) and overall survival (OS) of patients who underwent salvage surgery for residual or recurrent nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  Ninety-seven patients who had been treated with radiotherapy or chemoradiotherapy for NPC underwent a nasopharyngectomy for a residual or recurrent local tumor between November 1987 and June 2007. The subsequent minimum follow-up was 2 years. Univariate and multivariate analyses were performed to identify prognostic factors for LRFS and OS.
  
  
  RESULTS
  The 5-year LRFS and OS was 46.7% and 51.9%, respectively. On multivariate analysis for LRFS and OS, respectively, recurrent regional disease (hazard ratio [HR], 3.245; p = .008) and (HR, 4.990; p = .001), and positive surgical margins (HR, 5.963; p = .000), and (HR, 4.912; p = .000) were independent prognostic factors.
  
  
  CONCLUSIONS
  In patients undergoing surgical salvage nasopharyngectomy for residual or recurrent NPC, positive surgical margins have an independent negative influence on LRFS and OS.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin New Territories, Hong Kong Special Administrative Region, China. lexvlantis@cuhk.edu.hk
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Vlantis
authors.forename: Hing Sang
authors.initials: HS
authors.lastname: Chan
authors.forename: Michael C F
authors.initials: MC
authors.lastname: Tong
authors.forename: Brian K H
authors.initials: BK
authors.lastname: Yu
authors.forename: Michael K M
authors.initials: MK
authors.lastname: Kam
authors.forename: C Andrew
authors.initials: CA
authors.lastname: van Hasselt
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001707:Biopsy, Needle; D002277:Carcinoma; D059248:Chemoradiotherapy / Q000379:methods; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D010611:Pharyngectomy / Q000379:methods*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D016019:Survival Analysis; D016896:Treatment Outcome