Endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma: a review of 31 patients and analysis of the prognostic factors / 中国医师杂志

ABSTRACT

Objective To evaluate the efficacy of endoscopic nasopharyngectomy in the management of recurrent nasopharyngeal cancers (NPC) and to identify the prognostic factors.Methods Between september 2010 and october 2016,31 patients who received endoscopic nasopharyngectomy in our hospital for recurrent NPC were retrospectively reviewed.The clinical and pathological features of the patients,such as sex,age,T stage,pathological type,recurrence location,operation time,bleeding volume,perioperative complications,postoperative recurrence time,location and survival were recorded and analyzed,and the prognosis was observed.Results All patients underwent endoscopic resection of nasopharyngeal carcinoma locally,and no 1 cases received external nasal route surgery.All patients underwent successful endoscopic nasopharyngectomy.No patient was transferred to open approach.The mean operative time was (108.55 ± 34.36)min.The average blood loss was (23.05 ± 16.11)rnl.No serious postoperative complications occurred,no surgical deaths,and 1 cases had positive edge.Postoperative follow-up time was 3-82 months.During follow-up,29 cases survired,including that 9 patients survived with disease,1 patient concurrent oropharyngeal carcinoma,1 patient lost and 1 patient died.There were 6 cases of local recurrence,1 cases of liver metastasis and 2 cases of cervical lymph node metastasis after operation,2 patients with recurrent postoperative received endoscopic nasopharyngectomy and no recurrence of postoperative follow-up.One-year overall survival rate,disease-free survival rate and no local recurrence survival rate were 96.67％,80.00％ and 86.67％ respectively.Five-year disease-free survival rate was 61.80％.The progression free survival time was 2-82 (31.87 ± 23.26) months.Multivariate analysis showed that sex,age,first diagnosed T stage,and tumor necrosis were not the independent prognostic factor for survival in recurrent nasopharyngeal carcinoma patients.Conclusions Endoscopic nasopharyngectomy is a safe and effective procedure for the treatment of recurrent nasopharyngeal carcinoma.