Surgical salvage of persistent or recurrent nasopharyngeal carcinoma with maxillary swing approach - Critical appraisal after 2 decades

Background The purpose of this study was to report on our experience on salvage nasopharyngectomy using the maxillary swing approach for persistent or recurrent nasopharyngeal carcinoma after primary treatment. Methods Over the past 2 decades, we have performed salvage nasopharyngectomies for 246 pa...

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Bibliographic Details
Published in:Head & neck 2011-07, Vol.33 (7), p.969-975
Main Authors: Wei, William I., Chan, Jimmy Yu Wai, Ng, Raymond Wai Man, Ho, Wai Kuen
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Brachytherapy
Carcinoma
Combined Modality Therapy
Disease-Free Survival
Female
Humans
Length of Stay
long term results
Male
maxillary swing approach
Medical sciences
Middle Aged
Nasopharyngeal Carcinoma
Nasopharyngeal Neoplasms - drug therapy
Nasopharyngeal Neoplasms - mortality
Nasopharyngeal Neoplasms - pathology
Nasopharyngeal Neoplasms - radiotherapy
Nasopharyngeal Neoplasms - surgery
Neoplasm Recurrence, Local - mortality
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - surgery
Neoplasm, Residual
Otorhinolaryngology. Stomatology
persistent recurrent
Pharyngectomy - methods
Salvage Therapy - methods
surgical salvage
Tumors
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
Young Adult
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Summary:Background The purpose of this study was to report on our experience on salvage nasopharyngectomy using the maxillary swing approach for persistent or recurrent nasopharyngeal carcinoma after primary treatment. Methods Over the past 2 decades, we have performed salvage nasopharyngectomies for 246 patients. Thirty‐seven patients (15%) had persistent disease and 209 (85%) had recurrent tumors. Results All patients survived the operation with minimal morbidity. Negative resection margins were achieved in 191 patients (78%), and 55 patients (22%) had microscopic residual disease. The median follow‐up was 38 months. The 5‐year actuarial control of disease in the nasopharynx was 74%. The 5‐year disease‐free survival was 56%. Cox regression model identified the negative resection margin and the size of the tumor as 2 independent factors that affected local control of disease and survival. Conclusion Maxillary swing nasopharyngectomy is an effective salvage procedure for a small, persistent, or recurrent tumor in the nasopharynx after primary therapy. © 2010 Wiley Periodicals, Inc. Head Neck, 2011
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.21558