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5-year outcomes of salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma

OBJECTIVE: Recurrent nasopharyngeal carcinoma (rNPC) can be salvaged with re-irradiation, open nasopharyngectomy, and more recently endoscopic nasopharyngectomy. However, long-term outcomes of endoscopic approaches are lacking. Thus, we report 5-year outcomes following endoscopic nasopharyngectomy f...

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Autores principales: Thamboo, Andrew, Patel, Vishal S., Hwang, Peter H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7888158/
https://www.ncbi.nlm.nih.gov/pubmed/33597031
http://dx.doi.org/10.1186/s40463-020-00482-x
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author Thamboo, Andrew
Patel, Vishal S.
Hwang, Peter H.
author_facet Thamboo, Andrew
Patel, Vishal S.
Hwang, Peter H.
author_sort Thamboo, Andrew
collection PubMed
description OBJECTIVE: Recurrent nasopharyngeal carcinoma (rNPC) can be salvaged with re-irradiation, open nasopharyngectomy, and more recently endoscopic nasopharyngectomy. However, long-term outcomes of endoscopic approaches are lacking. Thus, we report 5-year outcomes following endoscopic nasopharyngectomy for rNPC. METHODS: Patients who underwent endoscopic nasopharyngectomy for rNPC between January 2000 and January 2012 were retrospectively reviewed. Patients were included if they had their first endoscopic nasopharyngectomy at least 5 years prior to this study. Presenting (cTNM) status and recurrent (rTNM) status for each recurrence was determined. Outcomes included margin status, disease recurrence, death, and complication rates. RESULTS: Thirteen patients were included. Four patients had a prior open nasopharyngectomy. Mean time follow-up was 74.3 months (range = 56.4–96 months). Negative margins were achieved in 77% of initial cases. Positive margins were associated with higher rT stages. Re-recurrence was seen in 6 patients, which was also associated with a higher cStage and rStage. All patients with positive margins had re-recurrence. Four patients required repeat endoscopic nasopharyngectomy and two received chemoradiation. All four with a second endoscopic procedure had further disease recurrence. Five-year local disease-free and overall survival rates were 53.9 and 84.6%, respectively. The minor complication rate was 52.6%, major operative complication rate was 0.0%, and late complication rate was 23.1%. CONCLUSION: Endoscopic nasopharyngectomy demonstrates promising 5-year overall survival rate for rT1 and rT2 cases of rNPC with favorable complication rates. Lower rStages were associated with a higher disease-free rate, and lower cStages were associated with improved overall prognosis. Close surveillance and prompt management of recurrences can be associated with favorable long-term tumor control. LEVEL OF EVIDENCE: 4 GRAPHICAL ABSTRACT: [Image: see text]
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spelling pubmed-78881582021-02-22 5-year outcomes of salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma Thamboo, Andrew Patel, Vishal S. Hwang, Peter H. J Otolaryngol Head Neck Surg Original Research Article OBJECTIVE: Recurrent nasopharyngeal carcinoma (rNPC) can be salvaged with re-irradiation, open nasopharyngectomy, and more recently endoscopic nasopharyngectomy. However, long-term outcomes of endoscopic approaches are lacking. Thus, we report 5-year outcomes following endoscopic nasopharyngectomy for rNPC. METHODS: Patients who underwent endoscopic nasopharyngectomy for rNPC between January 2000 and January 2012 were retrospectively reviewed. Patients were included if they had their first endoscopic nasopharyngectomy at least 5 years prior to this study. Presenting (cTNM) status and recurrent (rTNM) status for each recurrence was determined. Outcomes included margin status, disease recurrence, death, and complication rates. RESULTS: Thirteen patients were included. Four patients had a prior open nasopharyngectomy. Mean time follow-up was 74.3 months (range = 56.4–96 months). Negative margins were achieved in 77% of initial cases. Positive margins were associated with higher rT stages. Re-recurrence was seen in 6 patients, which was also associated with a higher cStage and rStage. All patients with positive margins had re-recurrence. Four patients required repeat endoscopic nasopharyngectomy and two received chemoradiation. All four with a second endoscopic procedure had further disease recurrence. Five-year local disease-free and overall survival rates were 53.9 and 84.6%, respectively. The minor complication rate was 52.6%, major operative complication rate was 0.0%, and late complication rate was 23.1%. CONCLUSION: Endoscopic nasopharyngectomy demonstrates promising 5-year overall survival rate for rT1 and rT2 cases of rNPC with favorable complication rates. Lower rStages were associated with a higher disease-free rate, and lower cStages were associated with improved overall prognosis. Close surveillance and prompt management of recurrences can be associated with favorable long-term tumor control. LEVEL OF EVIDENCE: 4 GRAPHICAL ABSTRACT: [Image: see text] BioMed Central 2021-02-17 /pmc/articles/PMC7888158/ /pubmed/33597031 http://dx.doi.org/10.1186/s40463-020-00482-x Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Original Research Article
Thamboo, Andrew
Patel, Vishal S.
Hwang, Peter H.
5-year outcomes of salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma
title 5-year outcomes of salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma
title_full 5-year outcomes of salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma
title_fullStr 5-year outcomes of salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma
title_full_unstemmed 5-year outcomes of salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma
title_short 5-year outcomes of salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma
title_sort 5-year outcomes of salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7888158/
https://www.ncbi.nlm.nih.gov/pubmed/33597031
http://dx.doi.org/10.1186/s40463-020-00482-x
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