Nasopharyngectomy for Recurrent Nasopharyngeal Cancer: A 2- to 17-Year Follow-up | Head and Neck Cancer | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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Original Article
March 2002

Nasopharyngectomy for Recurrent Nasopharyngeal Cancer: A 2- to 17-Year Follow-up

Author Affiliations

From the Division of Otolaryngology/Head and Neck Surgery (Drs Fee, Moir, and Choi) and Department of Radiation Oncology (Dr Goffinet), Stanford University, Stanford, Calif. Dr Choi is now with the Department of Otolaryngology, Yonsei University, Seoul, Korea.

Arch Otolaryngol Head Neck Surg. 2002;128(3):280-284. doi:10.1001/archotol.128.3.280

Objective  To review the 2- to 17-year outcome of nasopharyngectomy following local recurrence of nasopharyngeal carcinoma.

Design  Retrospective review.

Setting  University medical center.

Patients  Thirty-seven patients with biopsy-proven recurrent nasopharyngeal cancer followed up for a minimum of 2 years after transpalatal, transmaxillary, and/or transcervical resection with and without neck dissection.

Outcome  Clinical examination, magnetic resonance imaging, chest x-ray examination, and liver function tests to determine re-recurrence; unlimited follow-up.

Results  With a mean follow-up of 5.4 years, the crude, 5-year, overall, free-of-disease survival rate was 52%, local control at 5 years was 67%, and the 5-year actuarial survival rate was 60%. Survival by recurrent T stage (rT) was as follows: rT1, 73%; rT2, 40%; rT3, 14%; and rT4, 0%. Complications occurred in 54% and included 1 death from carotid artery injury and 1 patient with permanent pharyngeal plexus paralysis with resultant dysphagia. The remaining patients had transitory complications that spontaneously resolved, required further surgery (closure of palate fistula, debridement, and reapplication of skin graft), or required further medical therapy.

Conclusions  The results of this study are better than most published reports of additional irradiation for rT1 and rT2 lesions. More recent radiation studies that use radiosurgery or implants suggest promising early results. A randomized prospective study comparing surgery with additional irradiation for recurrent disease at the primary site is warranted.