[Clinical outcomes of salvage surgery for nasopharyngeal carcinoma after irradiation failure].

OBJECTIVE

To study salvage surgery for persistent or recurrent nasopharyngeal carcinoma after irradiation failure.

METHODS

A total of 84 cases underwent salvage surgery for persistent or recurrent nasopharyngeal carcinoma after irradiation failure between 1993 and 2009 was reviewed. rTNM stage: rT1 34 cases, rT2 27 cases, rT3 12 cases and rT4 11 cases; rN0 70 cases, rN1 9 cases and rN2 5 cases; No with distance metastatic. The salvage surgeries were performed using maxillary swing approach (47 cases), transcervical-mandibulo-palatal approach (21 cases), palate nasopharyngectomy (6 cases), lateral rhinotomy (7 cases), and maxillectomy (3 cases).

RESULTS

Persistent or recurrent nasopharyngeal carcinoma after irradiation failure was resected completely in 57 patients (67.9%) and there were microscopic residual diseases in 27 patients (32.1%). The median follow-up was 27 months. Postoperative recurrence occurred in 35 cases. Thirty-six patients died of recurrence, metastasis and other diseases. The overall 5 year survival rate was 43.6%. Cox regression analysis indicated the complete resection for persistent or recurrent disease and no cervical metastasis were two independent factors affecting survival.

CONCLUSIONS

Salvage surgery for persistent or recurrent nasopharyngeal carcinoma after irradiation failure is an effective treatment.