Salvage surgery for locally recurrent nasopharyngeal carcinoma - A 10-year experience
Salvage surgery for locally recurrent nasopharyngeal carcinoma - A 10-year experience
复制标题
DOI：
10.1016/j.otohns.2004.02.049
复制
发表时间：
2004-10-01
影响因子：
3.4
通讯作者：
Ueng, SH
中科院分区：
文献类型：
--
作者：
Chang, KP;Hao, SP;Ueng, SH
目标，评价鼻咽癌（NPC）放疗后原发性复发患者的挽救性手术治疗效果。研究设计和背景：三级转诊中心的前瞻性队列研究。从1993年7月至2002年12月，连续38例鼻咽癌放疗失败后原发复发的患者接受了经面部移位入路的挽救性手术。随访时间2 ~ 88个月。12例颅内和颅底侵犯需要联合手术。结果：3年生存率和局部控制率分别为60%和72.8%。12例颅内及颅底受侵患者中10例（83.3%）获得局部控制。无手术死亡，并发症发生率仅为13.2%。本研究的结果显示，挽救性手术的结果优于大多数已发表的复发性鼻咽癌再照射的文献。通过面部移位入路提供足够的暴露，颅底手术的综合概念，以及神经外科医生的合作，我们可以扩大挽救手术的手术适应症，切除许多晚期病变，死亡率和发病率可接受。
OBJECTIVE., To evaluate the result of salvage surgery for patients with primary recurrence of nasopharyngeal carcinoma (NPC) after radiation therapy.STUDY DESIGN AND SETTING: Prospective cohort at a tertiary referral center.PATIENTS AND METHODS. Thirty-eight consecutive patients with primary recurrence of NPC after radiation failure underwent salvage surgery for curative intention via the facial translocation approach from July 1993 to December 2002. The follow-up time ranged from 2 to 88 months. Twelve patients with intracranial and skull base invasion needed a combined neurosurgical approach. Eight patients had additional postoperative radiation therapy.RESULTS: The actuarial 3-year survival and local control rate was 60% and 72.8%, respectively. Ten (83.3%) of 12 patients with intracranial and skull base invasion achieved local control. There was no surgical mortality, and the morbidity rate was only 13.2%.CONCLUSION AND SIGNIFICANCE., The results of this study reveal better outcome of salvage surgery than that of most published literature of reirradiation for recurrent NPC. With the adequate exposure provided by the facial translocation approach, an integrated concept of skull base surgery, and the collaboration of neurosurgeons, we can extend our surgical indications of salvage surgery and resect many advanced lesions with acceptable mortality and morbidity.