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.