title: Extracranial/intracranial vascular bypass and craniofacial resection: New hope for patients with locally advanced recurrent nasopharyngeal carcinoma.
abstract: The purpose of this study was to investigate the oncologic outcome and quality of life after surgical treatment of locally advanced (rT3-rT4) recurrent nasopharyngeal carcinoma (NPC) using the staged extracranial/intracranial vascular bypass and combined craniofacial approach.
  
  
  
  We conducted a prospective study.
  
  
  
  Between 1998 and 2013, 28 patients with rT3 to rT4 tumors were treated with the proposed surgical protocol. Clear resection margin was achieved in 46.4%. The median follow-up was 42.6 months. The rate of local recurrence was 17.8%. The 5-year overall survival was 52%. There was no change in the mean global health system score after the extensive surgery, although the physical functioning scores deteriorated significantly. The most common symptoms experienced by patients were speech and swallowing problems.
  
  
  
  The proposed surgical treatment for locally advanced recurrent NPC was associated with satisfactory local tumor control and survival. Quality of life after surgery was reasonable, although multidisciplinary training was required to maximize the postoperative speech and swallowing function. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1404-E1412, 2016.
authors.affiliation: Department of Surgery, Division of Head and Neck Surgery, University of Hong Kong Medical Centre Queen Mary Hospital, Hong Kong SAR, China.
authors.forename: Jimmy Yu Wai
authors.initials: JY
authors.lastname: Chan
authors.affiliation: Department of Surgery, Division of Head and Neck Surgery, University of Hong Kong Medical Centre Queen Mary Hospital, Hong Kong SAR, China.
authors.forename: Stanley Thian Sze
authors.initials: ST
authors.lastname: Wong
authors.affiliation: Department of Surgery, Division of Head and Neck Surgery, University of Hong Kong Medical Centre Queen Mary Hospital, Hong Kong SAR, China.
authors.forename: Richie Chiu Lung
authors.initials: RC
authors.lastname: Chan
authors.affiliation: Department of Surgery, Division of Head and Neck Surgery, University of Hong Kong Medical Centre Queen Mary Hospital, Hong Kong SAR, China.
authors.forename: William Ignace
authors.initials: WI
authors.lastname: Wei
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life
keywords: craniofacial resection; locally advanced; quality of life; recurrent nasopharyngeal carcinoma; survival