Introduction
N asopharyngeal carcinoma (NPC) is a common malignant tumor in
southern China.1 Radiotherapy is the first choice of
treatment for NPC owing to sensitivity of the tumor in early stages.
However, approximately 10% of patients experience local recurrence of
the tumor after radiotherapy.2 After the first course
of radiotherapy, patients often demonstrate hyperplasia of fibers in the
nasopharynx and poor local circulation due to local vascular occlusion.
Repeating radiotherapy may result in low efficacy and complications,
which can seriously damage the quality of life of patients, sometimes
leading to death. In addition, mutations may occur in the residual tumor
after the first treatment or other mechanisms that may persist,
resulting in tumor resistance to subsequent treatment sessions.
Therefore, surgical treatment of residual and recurrent NPC is
advocated. You et al. reported that salvage endoscopic nasopharyngectomy
may be more effective for maximizing survival and quality of life
benefits and minimizing treatment-related complications in patients with
recurrent NPC, as compared with intensity modulated radiation
therapy.3
E ndoscopic nasopharyngectomy is less invasive and does not
result in facial scars as compared to conventional maxillary swing
approach for resection of recurrent tumors.4,5Therefore, several institutions have started performing endoscopic
nasopharyngectomy for the resection of residual and recurrent NPC.
Salvage surgery for recurrent NPC is challenging due to the risk of
damage to various neurovascular structures and potentially the dura
mater. Moreover, only few retrospective studies have been conducted to
assess the survival and prognostic factors of salvage surgery in
recurrent NPC. Wong et al. reported a 2-year overall survival rate of
66.7% during a median follow-up of 19.4 months in 15 patients with
recurrent NPC (rT3 and rT4 tumors) who underwent endoscopic endonasal
nasopharyngectomy.6 In our study, we focused on the
demographics, treatment outcomes, and prognostic factors associated with
salvage endoscopic nasopharyngectomy in recurrent NPC.