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Nasopharyngectomy for Recurrent Nasopharyngeal Cancer
A 2- to 17-Year Follow-up
Willard E. Fee, Jr, MD;
Melinda S. Moir, MD;
Eun Chang Choi, MD;
Don Goffinet, MD
Arch Otolaryngol Head Neck Surg. 2002;128:280-284.
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.
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.
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