Article

Endoscopic nasopharyngectomy for locally recurrent nasopharyngeal carcinoma.

State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China.
The Laryngoscope (impact factor: 1.75). 03/2009; 119(3):516-22. DOI:10.1002/lary.20133 pp.516-22
Source: PubMed

ABSTRACT Nasopharyngectomy is the primary treatment for locally recurrent nasopharyngeal carcinoma (rNPC). However, oncological nasopharyngectomy is difficult to achieve, even using extranasal surgical approaches, with potential risks of severe functional disabilities and serious complications. This report introduces an innovative, minimally invasive, oncological, endoscopic nasopharyngectomy.
Between October 2004 and January 2008, 37 rNPC patients received endoscopic nasopharyngectomy, with 17, 4, 14, and 2 cases of rT1N0M0, rT2aN0M0, rT2bN0M0, and rT3N0M0, respectively. Tumors in all patients were confined to the nasopharyngeal cavity, postnaris, nasal septum, superficial parapharyngeal space, or the base of the sphenoid sinus. Nasopharyngeal malignancies and adequate surgical margin (>0.5-1.0 cm) were required for continuous en bloc resection.
Among the 37 endoscopic nasopharyngectomies, 35 achieved en bloc tumor resection with negative surgical margins. In the remaining two cases, the tumors were dissected into small blocks, and one had positive surgical margins. No patient received postoperative radiotherapy and no severe complication was observed. During the 6-45 months of follow-up (median, 24 months), five patients experienced in situ residual or recurrence with 1 submaxillary lymphatic metastasis. One patient developed distant metastases and died, one died of intracranial infection, and one died of another cancer. The 2-year overall survival rate, local relapse-free survival rate, and progression-free survival rate were 84.2%, 86.3%, and 82.6%, respectively.
Appropriate endoscopic nasopharyngectomy is a minimally invasive, safe, and promising surgical modality for the en bloc excision of rNPCs with encouraging short-term outcome. Long-term patient follow-up is ongoing.

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    Article: Current treatment options for recurrent nasopharyngeal cancer.
    Carlos Suárez, Juan P Rodrigo, Alessandra Rinaldo, Johannes A Langendijk, Ashok R Shaha, Alfio Ferlito
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    ABSTRACT: Loco-regional control rate of nasopharyngeal carcinoma (NPC) has improved significantly in the past decade. However, local recurrence still represents a major cause of mortality and morbidity in advanced stages, and management of local failure remains a challenging issue in NPC. The best salvage treatment for local recurrent NPC remains to be determined. The options include brachytherapy, external radiotherapy, stereotactic radiosurgery, and nasopharyngectomy, either alone or in different combinations. In this article we will discuss the different options for salvage of locally recurrent NPC. Retreatment of locally recurrent NPC using radiotherapy, alone or in combination with other treatment modalities, as well as surgery, can result in long-term local control and survival in a substantial proportion of patients. For small-volume recurrent tumors (T1-T2) treated with external radiotherapy, brachytherapy or stereotactic radiosurgery, comparable results to those obtained with surgery have been reported. In contrast, treatment results of advanced-stage locally recurrent NPC are generally more satisfactory with surgery (with or without postoperative radiotherapy) than with reirradiation.
    Archives of Oto-Rhino-Laryngology 12/2010; 267(12):1811-24. · 1.29 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

37 endoscopic nasopharyngectomies
 
37 rNPC patients
 
adequate surgical margin
 
Appropriate endoscopic nasopharyngectomy
 
continuous en bloc resection
 
en bloc excision
 
en bloc tumor resection
 
endoscopic nasopharyngectomy
 
extranasal surgical approaches
 
Long-term patient follow-up
 
nasopharyngeal cavity
 
negative surgical margins
 
oncological nasopharyngectomy
 
primary treatment
 
promising surgical modality
 
recurrent nasopharyngeal carcinoma
 
severe functional disabilities
 
short-term outcome
 
sphenoid sinus
 
superficial parapharyngeal space