title: Multivariate analysis of prognostic factors for salvage nasopharyngectomy via the maxillary swing approach.
abstract: BACKGROUND
  The purpose of this study was to investigate the prognostic factors for salvage nasopharyngectomy.
  
  
  METHODS
  A retrospective review was conducted on maxillary swing nasopharyngectomy performed between 1998 and 2010. Univariate and multivariate analyses identified prognostic factors affecting actuarial local tumor control and overall survival.
  
  
  RESULTS
  The median follow-up duration was 52 months. Among the 268 patients, 79.1% had clear resection margins. The 5-year actuarial local tumor control and overall survival was 74% and 62.1%, respectively. On multivariate analysis, tumor size, resection margin status, and gross tumor in the sphenoid sinus were independent prognostic factors for local tumor control. For overall survival, resection margin status, synchronous cervical nodal recurrence, and cavernous sinus invasion had a negative influence on overall survival after surgery.
  
  
  CONCLUSIONS
  Extent of nasopharyngectomy should be tailored to the individual tumor to achieve clear resection margins. Cavernous sinus invasion is associated with poor survival outcome, and detailed counseling and meticulous surgical planning is crucial in such circumstances.
authors.affiliation: Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong, Special Administrative Regions of the, People's Republic of China.
authors.forename: Jimmy Yu Wai
authors.initials: JY
authors.lastname: Chan
authors.forename: Victor Shing Howe
authors.initials: VS
authors.lastname: To
authors.forename: Velda Ling Yu
authors.initials: VL
authors.lastname: Chow
authors.forename: Stanley Thian Sze
authors.initials: ST
authors.lastname: Wong
authors.forename: William Ignace
authors.initials: WI
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002426:Cavernous Sinus / Q000473:pathology; D059248:Chemoradiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009303:Nasopharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D010611:Pharyngectomy / Q000379:methods*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D013101:Sphenoid Sinus / Q000473:pathology
keywords: maxillary swing nasopharyngectomy; multivariate analysis; prognostic factors; recurrent nasopharyngeal carcinoma; salvage surgery