[Salvage surgical operation via endoscopic transnasal approach for local persistent or recurrent nasopharyngeal carcinoma].

BACKGROUND & OBJECTIVE: Some patients with local persistent or recurrent nasopharyngeal carcinoma (NPC) could achieve long-term survival after re-irradiation, but the irradiation-related complications are severe. Salvage surgical operation has similar, even better, curative effect, with no irradiation injury, but conventional surgical approaches may lead to serious damage, and unclear view of operation field is the obstacle for en bloc excision of the tumor. This study was to explore a new salvage surgical operation via mini-invasive endoscopic transnasal approach for recurrent NPC. METHODS: Endoscopic nasopharyngectomy via mini-invasive endoscopic transnasal approach was performed in 25 patients with local persistent or recurrent NPC after radiotherapy between Sep. 2004 and Jan. 2007 in Cancer Center of Sun Yat-sen University. Local control conditions and complications were assessed. RESULTS: All patients received successful radical resection via endoscopic transnasal approach; only 1 had positive surgical margin. No one received postoperative radiotherapy. During follow-up of 3-31 months (median, 13 months), 1 patient had local persistence, 3 had local recurrence, but none had distant metastasis or death. The 1-year overall survival rate was 100%; the 1-year recurrence-free survival rate was 86.0%. No trismus, dysphagia, dysphonia, other surgical complications, and perioperative death occurred. CONCLUSIONS: Salvage surgical operation via endoscopic transnasal approach can expose the whole nasopharynx and the shallow parapharynx for an oncologic resection of local persistent or recurrent NPC. The complications are few and mild; the short-term results are satisfactory.