Critical appraisal of maxillary swing approach for nasopharyngeal carcinoma

Background: The aim of the current study was to report results of salvage nasopharyngectomy using the maxillary swing approach for persistent or recurrent nasopharyngeal carcinoma after primary treatment. Methods: Between 1989 and 2011, Nasopharyngectomies were performed in 312 patients. Data were composed of retrospective review of records of the first 72 patients followed by a prospective collection of data for the remaining patients. Results: Among the patients, 41 (13.1%) had persistent tumours and 271 (86.9%) had recurrent disease. Curative resection was achieved in 248 (79.5%) patients. All patients survived the operations. The median follow up duration was 34 months. The overall 5-year actuarial local tumour control was 74% and the overall 5-year disease-free survival was 56%. Those with negative resection margins on frozen section and tumour size less than 1.5 cm in diameter had significantly better local tumour control in the nasopharynx as well as disease-free survival. Conclusions: Maxillary swing nasopharyngectomy is an effective salvage procedure for small, persistent or recurrent tumour in the nasopharynx after primary therapy.