title: Endoscopic surgery for recurrent undifferentiated nasopharyngeal carcinoma.
abstract: One of the biggest challenges for otolaryngologists is represented by the locally recurrent undifferentiated nasopharyngeal carcinoma (uNPC). Despite improvements in its treatment options, such as modern radiotherapy, chemotherapy, or external surgical approaches, the risk for severe complications, functional disabilities, and even death remains considerable. Over the years, advances in endoscopic surgery have led to a new alternative in the salvage surgery for recurrent uNPC: the nasopharyngeal endoscopic resection (NER). We retrospectively reviewed clinical records of 8 patients (6 men and 2 women), who underwent NER for recurrent T1 (rT1) locally recurrent uNPC between 2008 and 2011. Together with resections for subsequent recurrences, a total of 9 NERs were performed by a single surgeon with curative intent. Negative margins were obtained for the whole group of patients. After a mean follow-up period of 27 months (range, 16-54 mo), all the patients had no evidence of the disease. We had only 1 recurrence after 7 months. Two-year overall survival and disease-free survival rates were 100% and 88.9%, respectively. Only 1 patient presented with a complication, osteitis. Nasopharyngeal endoscopic resection can be considered a valid and promising treatment option for rT1 locally recurrent uNPC, showing encouraging short-term outcomes and complication rate. Long-term follow-up is needed to state the efficacy of NER, together with a larger number of patients.
authors.affiliation: From the *Operative Unit of Otolaryngology and Otosurgery, Padua University, Padua, Italy; and †Second Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania.
authors.forename: Enzo
authors.initials: E
authors.lastname: Emanuelli
authors.forename: Silviu
authors.initials: S
authors.lastname: Albu
authors.forename: Diego
authors.initials: D
authors.lastname: Cazzador
authors.forename: Barbara
authors.initials: B
authors.lastname: Pedruzzi
authors.forename: Gregorio
authors.initials: G
authors.lastname: Babighian
authors.forename: Alessandro
authors.initials: A
authors.lastname: Martini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma; D018572:Disease-Free Survival; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D009305:Nasopharynx / Q000473:pathology / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*