Skip to main content
Erschienen in: European Archives of Oto-Rhino-Laryngology 1/2017

12.08.2016 | Rhinology

A preliminary report on the role of endoscopic endonasal nasopharyngectomy in recurrent rT3 and rT4 nasopharyngeal carcinoma

verfasst von: Eugene Hung Chih Wong, Yew Toong Liew, Mohd Zulkiflee Abu Bakar, Elizabeth Yenn Lynn Lim, Narayanan Prepageran

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

Endoscopic endonasal nasopharyngectomy (EEN) has become increasingly used for recurrent nasopharyngeal carcinoma (rNPC) due to reduced functional and cosmetic morbidities compared to conventional external approach. Majority of the existing studies on EEN focused on patients with lower recurrent staging of rT1 and rT2. The aims of this study were to provide a preliminary report on the outcome of EEN performed in patients with advanced (rT3 and rT4) rNPC, and to determine the prognostic factors for patients’ survival. All patients who underwent EEN for rNPC between January 2003 and December 2015 inclusive were analyzed. All surgeries were performed in University Malaya Medical Centre in Kuala Lumpur and Queen Elizabeth Hospital in Sabah, by a single surgeon. We reported the 2-year overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS) and any related complications and significant prognostic factors. Fifteen patients with recurrent NPC (2 rT3 and 13 rT4 tumours) underwent EEN over the 13 years period. The mean age was 50.4 years (range 30–65) and the mean follow-up period was 28.7 months (range 9–81 weeks). The 2-year OS, DFS and DSS were 66.7 % (mean 19.4 months), 40 % (mean 15.7 months) and 73.3 % (mean 20.2 months), respectively. No severe operative complications were encountered. No independent prognostic factors for survival outcome were identified. This is the first preliminary report in English that exclusively looked at the use of EEN in advanced rT3 and rT4 NPCs, showing favourable patient outcome. However, further long-term follow-up of patients is required.
Literatur
1.
Zurück zum Zitat Yu MC, Yuan JM (2002) Epidemiology of nasopharyngeal carcinoma. Semin Cancer Biol 12:421–429CrossRefPubMed Yu MC, Yuan JM (2002) Epidemiology of nasopharyngeal carcinoma. Semin Cancer Biol 12:421–429CrossRefPubMed
2.
3.
Zurück zum Zitat Ong YK, Solares CA, Lee S et al (2011) Endoscopic nasopharyngectomy and its role in managing locally recurrent nasopharyngeal carcinoma. Otolaryngol Clin North Am 44:1141–1154CrossRefPubMed Ong YK, Solares CA, Lee S et al (2011) Endoscopic nasopharyngectomy and its role in managing locally recurrent nasopharyngeal carcinoma. Otolaryngol Clin North Am 44:1141–1154CrossRefPubMed
4.
Zurück zum Zitat Sun X, Su S, Chen C et al (2014) Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma: an analysis of survival and treatment toxicities. Radiother Oncol 110:398–403CrossRefPubMed Sun X, Su S, Chen C et al (2014) Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma: an analysis of survival and treatment toxicities. Radiother Oncol 110:398–403CrossRefPubMed
5.
Zurück zum Zitat You R, Zou X, Wang SL et al (2015) New surgical staging system for patients with recurrent nasopharyngeal carcinoma based on the AJCC/UICC rTNM classification system. Eur J Cancer 51:1771–1779CrossRefPubMed You R, Zou X, Wang SL et al (2015) New surgical staging system for patients with recurrent nasopharyngeal carcinoma based on the AJCC/UICC rTNM classification system. Eur J Cancer 51:1771–1779CrossRefPubMed
6.
Zurück zum Zitat Vlantis AC, Yu BK, Kam MK et al (2008) Nasopharyngectomy: does the approach to the nasopharynx influence survival? Otolaryngol Head Neck Surg 139:40–46CrossRefPubMed Vlantis AC, Yu BK, Kam MK et al (2008) Nasopharyngectomy: does the approach to the nasopharynx influence survival? Otolaryngol Head Neck Surg 139:40–46CrossRefPubMed
7.
Zurück zum Zitat Leung TW, Tung SY, Sze WK et al (2000) Salvage radiation therapy for locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 48:1331–1338CrossRefPubMed Leung TW, Tung SY, Sze WK et al (2000) Salvage radiation therapy for locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 48:1331–1338CrossRefPubMed
8.
Zurück zum Zitat Yoshizaki T, Wakisaka N, Murono S et al (2005) Endoscopic nasopharyngectomy for patients with recurrent nasopharyngeal carcinoma at the primary site. Laryngoscope 115:1517–1519CrossRefPubMed Yoshizaki T, Wakisaka N, Murono S et al (2005) Endoscopic nasopharyngectomy for patients with recurrent nasopharyngeal carcinoma at the primary site. Laryngoscope 115:1517–1519CrossRefPubMed
9.
Zurück zum Zitat Roh JL, Park CI (2006) Transseptal laser resection of recurrent carcinoma confined to the nasopharynx. Laryngoscope 116:839–841CrossRefPubMed Roh JL, Park CI (2006) Transseptal laser resection of recurrent carcinoma confined to the nasopharynx. Laryngoscope 116:839–841CrossRefPubMed
10.
Zurück zum Zitat Chen MK, Lai JC, Chang CC et al (2007) Minimally invasive endoscopic nasopharyngectomy in the treatment of recurrent T1-2a nasopharyngeal carcinoma. Laryngoscope 117:894–896CrossRefPubMed Chen MK, Lai JC, Chang CC et al (2007) Minimally invasive endoscopic nasopharyngectomy in the treatment of recurrent T1-2a nasopharyngeal carcinoma. Laryngoscope 117:894–896CrossRefPubMed
11.
Zurück zum Zitat Rohaizam J, Subramaniam SK, Vikneswaran T et al (2009) Endoscopic nasopharyngectomy: the Sarawak experience. Med J Malays 64:213–215 Rohaizam J, Subramaniam SK, Vikneswaran T et al (2009) Endoscopic nasopharyngectomy: the Sarawak experience. Med J Malays 64:213–215
12.
Zurück zum Zitat Ko JY, Wang CP, Ting LL et al (2009) Endoscopic nasopharyngectomy with potassium-titanyl-phosphate (KTP) laser for early locally recurrent nasopharyngeal carcinoma. Head Neck 31:1309–1315CrossRefPubMed Ko JY, Wang CP, Ting LL et al (2009) Endoscopic nasopharyngectomy with potassium-titanyl-phosphate (KTP) laser for early locally recurrent nasopharyngeal carcinoma. Head Neck 31:1309–1315CrossRefPubMed
13.
Zurück zum Zitat Chen MY, Wen WP, Guo X et al (2009) Endoscopic nasopharyngectomy for locally recurrent nasopharyngeal carcinoma. Laryngoscope 119:516–522CrossRefPubMed Chen MY, Wen WP, Guo X et al (2009) Endoscopic nasopharyngectomy for locally recurrent nasopharyngeal carcinoma. Laryngoscope 119:516–522CrossRefPubMed
14.
Zurück zum Zitat Ho AS, Kaplan MJ, Fee WE Jr et al (2012) Targeted endoscopic salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma. Int Forum Allergy Rhinol 2:166–173CrossRefPubMed Ho AS, Kaplan MJ, Fee WE Jr et al (2012) Targeted endoscopic salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma. Int Forum Allergy Rhinol 2:166–173CrossRefPubMed
15.
Zurück zum Zitat Hsu NI, Shen PH, Chao SS et al (2014) En bloc resection concept for endoscopic endonasal nasopharyngectomy: surgical anatomy and outcome. Chin Med J (Engl) 127:2934–2939 Hsu NI, Shen PH, Chao SS et al (2014) En bloc resection concept for endoscopic endonasal nasopharyngectomy: surgical anatomy and outcome. Chin Med J (Engl) 127:2934–2939
16.
Zurück zum Zitat Chen Z, Qiu Q (2015) Analysis of clinical efficacy and the quality of life after endoscopic nasopharyngectomy for residual or recurrent nasopharyngeal carcinoma. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 50:896–903PubMed Chen Z, Qiu Q (2015) Analysis of clinical efficacy and the quality of life after endoscopic nasopharyngectomy for residual or recurrent nasopharyngeal carcinoma. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 50:896–903PubMed
17.
Zurück zum Zitat Sun X, Liu J, Wang H et al (2015) Endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma: a review of 71 patients and analysis of the prognostic factors. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 50:890–895PubMed Sun X, Liu J, Wang H et al (2015) Endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma: a review of 71 patients and analysis of the prognostic factors. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 50:890–895PubMed
18.
Zurück zum Zitat You R, Zou X, Hua YJ et al (2015) Salvage endoscopic nasopharyngectomy is superior to intensity-modulated radiation therapy for local recurrence of selected T1–T3 nasopharyngeal carcinoma—a case-matched comparison. Radiother Oncol 115:399–406CrossRefPubMed You R, Zou X, Hua YJ et al (2015) Salvage endoscopic nasopharyngectomy is superior to intensity-modulated radiation therapy for local recurrence of selected T1–T3 nasopharyngeal carcinoma—a case-matched comparison. Radiother Oncol 115:399–406CrossRefPubMed
19.
Zurück zum Zitat Greene FL, Sobin LH (2009) A worldwide approach to the TNM staging system: collaborative efforts of the AJCC and UICC. J Surg Oncol 99:269–272CrossRefPubMed Greene FL, Sobin LH (2009) A worldwide approach to the TNM staging system: collaborative efforts of the AJCC and UICC. J Surg Oncol 99:269–272CrossRefPubMed
20.
Zurück zum Zitat Bian X, Chen H, Liao L (2012) A retrospective study of salvage surgery for recurrent nasopharyngeal carcinoma. Int J Clin Oncol 17:212–217CrossRefPubMed Bian X, Chen H, Liao L (2012) A retrospective study of salvage surgery for recurrent nasopharyngeal carcinoma. Int J Clin Oncol 17:212–217CrossRefPubMed
21.
Zurück zum Zitat Lu TX, Mai WY, Teh BS et al (2004) Initial experience using intensity-modulated radiotherapy for recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 58:682–687CrossRefPubMed Lu TX, Mai WY, Teh BS et al (2004) Initial experience using intensity-modulated radiotherapy for recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 58:682–687CrossRefPubMed
22.
Zurück zum Zitat Yu KH, Leung SF, Tung SY et al (2005) Survival outcome of patients with nasopharyngeal carcinoma with first local failure: a study by the Hong Kong Nasopharyngeal Carcinoma Study Group. Head Neck 27:397–405CrossRefPubMed Yu KH, Leung SF, Tung SY et al (2005) Survival outcome of patients with nasopharyngeal carcinoma with first local failure: a study by the Hong Kong Nasopharyngeal Carcinoma Study Group. Head Neck 27:397–405CrossRefPubMed
23.
Zurück zum Zitat Wang Y, Wang ZQ, Jiang YX et al (2016) A triplet chemotherapy regimen of cisplatin, fluorouracil and paclitaxel for locoregionally recurrent nasopharyngeal carcinoma cases contraindicated for re-irradiation/surgery. Expert Opin Pharmacother 17:1585–1590CrossRefPubMed Wang Y, Wang ZQ, Jiang YX et al (2016) A triplet chemotherapy regimen of cisplatin, fluorouracil and paclitaxel for locoregionally recurrent nasopharyngeal carcinoma cases contraindicated for re-irradiation/surgery. Expert Opin Pharmacother 17:1585–1590CrossRefPubMed
24.
Zurück zum Zitat Yu YH, Xia WX, Shi JL et al (2016) A model to predict the risk of lethal nasopharyngeal necrosis after re-irradiation with intensity-modulated radiotherapy in nasopharyngeal carcinoma patients. Chin J Cancer 35:59CrossRefPubMedPubMedCentral Yu YH, Xia WX, Shi JL et al (2016) A model to predict the risk of lethal nasopharyngeal necrosis after re-irradiation with intensity-modulated radiotherapy in nasopharyngeal carcinoma patients. Chin J Cancer 35:59CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Hua YJ, Han F, Lu LX et al (2012) Long-term treatment outcome of recurrent nasopharyngeal carcinoma treated with salvage intensity modulated radiotherapy. Eur J Cancer 48:3422–3428CrossRefPubMed Hua YJ, Han F, Lu LX et al (2012) Long-term treatment outcome of recurrent nasopharyngeal carcinoma treated with salvage intensity modulated radiotherapy. Eur J Cancer 48:3422–3428CrossRefPubMed
26.
Zurück zum Zitat Chua DT, Sham JS, Au GK (2005) Induction chemotherapy with cisplatin and gemcitabine followed by reirradiation for locally recurrent nasopharyngeal carcinoma. Am J Clin Oncol 28:464–471CrossRefPubMed Chua DT, Sham JS, Au GK (2005) Induction chemotherapy with cisplatin and gemcitabine followed by reirradiation for locally recurrent nasopharyngeal carcinoma. Am J Clin Oncol 28:464–471CrossRefPubMed
27.
Zurück zum Zitat Chua DT, Sham JS, Kwong DL et al (1998) Locally recurrent nasopharyngeal carcinoma: treatment results for patients with computed tomography assessment. Int J Radiat Oncol Biol Phys 41:379–386CrossRefPubMed Chua DT, Sham JS, Kwong DL et al (1998) Locally recurrent nasopharyngeal carcinoma: treatment results for patients with computed tomography assessment. Int J Radiat Oncol Biol Phys 41:379–386CrossRefPubMed
28.
Zurück zum Zitat Al-Sheibani S, Zanation AM, Carrau RL et al (2011) Endoscopic endonasal transpterygoid nasopharyngectomy. Laryngoscope 121:2081–2089CrossRefPubMed Al-Sheibani S, Zanation AM, Carrau RL et al (2011) Endoscopic endonasal transpterygoid nasopharyngectomy. Laryngoscope 121:2081–2089CrossRefPubMed
29.
Zurück zum Zitat Chan JY, Wei WI (2016) Impact of resection margin status on outcome after salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma. Head Neck 38(Suppl 1):594–599CrossRef Chan JY, Wei WI (2016) Impact of resection margin status on outcome after salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma. Head Neck 38(Suppl 1):594–599CrossRef
30.
Zurück zum Zitat Vlantis AC, Tsang RK, Yu BK et al (2007) Nasopharyngectomy and surgical margin status: a survival analysis. Arch Otolaryngol Head Neck Surg 133:1296–1301CrossRefPubMed Vlantis AC, Tsang RK, Yu BK et al (2007) Nasopharyngectomy and surgical margin status: a survival analysis. Arch Otolaryngol Head Neck Surg 133:1296–1301CrossRefPubMed
Metadaten
Titel
A preliminary report on the role of endoscopic endonasal nasopharyngectomy in recurrent rT3 and rT4 nasopharyngeal carcinoma
verfasst von
Eugene Hung Chih Wong
Yew Toong Liew
Mohd Zulkiflee Abu Bakar
Elizabeth Yenn Lynn Lim
Narayanan Prepageran
Publikationsdatum
12.08.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 1/2017
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-016-4248-2

Weitere Artikel der Ausgabe 1/2017

European Archives of Oto-Rhino-Laryngology 1/2017 Zur Ausgabe

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.