Salvage Endoscopic Nasopharyngectomy for Recurrent Nasopharyngeal Carcinoma in a Non-endemic Area

Overview

Journal Eur Arch Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2024 Mar 14

PMID 38480535

Authors

Marco Valentini

Alessia Lambertoni

Giorgio Sileo

Alberto Daniele Arosio

Gianluca Dalfino

Fabio Pedretti

Apostolos Karligkiotis

Maurizio Bignami

Paolo Battaglia

Paolo Castelnuovo

Mario Turri-Zanoni

Affiliations

Soon will be listed here.

Abstract

Purpose: To analyze oncological outcomes of endoscopic surgical treatment of locally recurrent EBV-related undifferentiated non-keratinizing nasopharyngeal carcinoma (uNK-NPC) in a non-endemic area.

Methods: Retrospective review of patients affected by recurrent uNK-NPC treated with nasopharyngeal endoscopic resection (NER) in a tertiary-care referral center from 2003 to 2022, by evaluating survival rates, prognostic factors, and follow-up strategies.

Results: The oncological outcomes of 41 patients were analyzed, over a mean follow-up period of 57 months. The 5-year overall, disease-specific, and disease-free survival of the cohort were 60.7% ± 8.9%, 69% ± 9%, and 39.7% ± 9.2%, respectively. The local (rT) and regional (rN) extension of recurrent disease, stage of disease, and status of resection margins appeared to significantly influence survivals. After a mean follow-up period of 21 months, a further recurrence after NER was observed in 36.6% of cases. Skull base osteonecrosis induced by previous irradiation and post-surgical bone remodeling represent the major challenges for early detection of further local relapses during postoperative follow-up.

Conclusion: NER appeared as a safe and effective treatment for recurrent uNK-NPC. The adequate selection of patients eligible for NER is essential, to maximize the chances to cure and minimize the risk of local complications.

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