Nasopharyngectomy for recurrent nasopharyngeal carcinoma: a review of 53 patients and prognostic factors
Nasopharyngectomy for recurrent nasopharyngeal carcinoma: a review of 53 patients and prognostic factors
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DOI：
10.1080/00016480701813806
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发表时间：
2008-01-01
影响因子：
1.4
通讯作者：
Fang, Ku-Hao
中科院分区：
文献类型：
--
作者：
Hao, Sheng-Po;Tsang, Ngan-Ming;Fang, Ku-Hao
结论。挽救手术是鼻咽癌（NPC）原发性复发的合理治疗方法。颅底手术对于更晚期鼻咽癌局部复发患者可以起到抢救作用。目标。本研究的目的是报告接受挽救性鼻咽切除术的局部失败的 (NPC) 患者的局部控制和总体生存结果，并确定预后因素。患者和方法。回顾性分析1993年7月至2006年12月期间连续收治的53例鼻咽癌原发复发并行挽救性手术以达到治愈目的的患者。随访时间为5.1至142.2个月。复发性鼻咽癌分期病例数如下：Ⅰ期26例；Ⅲ期26例。第二阶段，9； III期10例，IV期8例。50例患者在抢救手术前接受了1个疗程的放射治疗，3例患者在挽救手术前接受了2个疗程的放射治疗。鼻咽切除术中，2例患者接受内镜手术，33例患者接受面部移位术，18例患者接受颅面切除术。术后辅助治疗包括放射治疗，4例；放射外科8例；同步放化疗7例；并化疗2例。结果。 5年局部控制率为T1，58.3%； T2，27.8%； T3，53.3%； T4，75.0%；所有阶段均为 53.6%。 5年总生存率为I期，64.8%； II期，38.1%； III期，25.9%； IV期，46.9%；所有阶段均为 48.7%。多变量分析显示，性别、切缘状态、辅助治疗类型和咽旁间隙受累是局部控制的显着影响因素，而硬脑膜或脑受累、局部复发和辅助治疗类型是生存的显着影响因素。
Conclusions. Salvage surgery is a justified treatment for primary recurrence of nasopharyngeal carcinoma (NPC). Skull base surgery can play a role in rescuing patients with more advanced local recurrence of NPC. Objectives. The purpose of this study was to report the local control and overall survival outcome of patients with (NPC) with local failure who received salvage nasopharyngectomy and to identify prognostic factors. Patients and methods. Fifty-three consecutive patients who had primary recurrence of NPC and underwent salvage surgery with curative intention from July 1993 to December 2006 were retrospectively reviewed. The follow-up time ranged from 5.1 to 142.2 months. The numbers of cases of recurrent NPC stage were as follows: stage I, 26; stage II, 9; stage III, 10 and stage IV, 8. Fifty patients had one course of radiation therapy while 3 had two courses of radiation therapy before the salvage surgery. For the nasopharyngectomy, 2 patients underwent endoscopic approach and 33 underwent facial translocation, while 18 had craniofacial resection. Postoperative adjuvant treatment included radiation therapy, 4 cases; radiosurgery, 8 cases; concurrent chemoradiation therapy, 7 cases; and chemotherapy, 2 cases. Results. The 5-year local control rates were T1, 58.3%; T2, 27.8%; T3, 53.3%; T4, 75.0%; and all stages, 53.6%. The 5-year overall survival rates were stage I, 64.8%; stage II, 38.1%; stage III, 25.9%; stage IV, 46.9%; and all stages, 48.7%. Multivariate analysis revealed that gender, margin status, adjuvant treatment type and parapharyngeal space involvement were significant impact factors of local control, whereas dura or brain involvement, local recurrence and adjuvant treatment type were significant impact factors of survival.