A retrospective study of salvage surgery for recurrent nasopharyngeal carcinoma

Nasopharyngeal carcinoma is sensitive to radiotherapy. When there is local relapse, re-irradiation treatment is inevitably associated with serious complications and decreased quality of life. Surgical resection offers an alternative treatment option with acceptable morbidity. Seventy-one consecutive patients with primary recurrence of nasopharyngeal carcinoma after radiation underwent nasopharyngectomy from January 1, 1990 to June 30, 2006. Follow-up ranged from 12 to 127 months. The actuarial 1-, 2-, 3-, and 5-year survival rates were 88.1, 62.1, 48.9, and 42.1%, respectively. The 1-, 2-, 3-, and 5-year local control rates were 74.6, 61.9, 56.3, and 53.5%, respectively. There was no surgical mortality. The 3-year overall survival rates for recurrent T1, T2, T3, and T4 disease after surgery were 56, 61.1, 30.6, and 0%, respectively; the corresponding 5-year overall survival rates were 49.1, 24.7, 0, and 0%, respectively. Other prognostic factors with a negative effect on survival include lymph node metastasis, invasion of skull base and parapharyngeal space, and positive margin. Advances in skull base surgery make possible the effective control of primary recurrence of nasopharyngeal carcinoma for patients with rT1 and rT2 stages, with acceptable mortality and morbidity.