Liu Juan, Yu Huapeng, Sun Xicai, Wang Dehui, Gu Yurong, Liu Quan, Wang Huan, Han Wade, Fry Allison
Department of Otolaryngology, Eye Ear Nose and Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, People's Republic of China.
Florida Ear Nose Throat & Facial Plastic Surgery, Kissimmee, USA.
Int J Clin Oncol. 2017 Oct;22(5):834-842. doi: 10.1007/s10147-017-1143-9. Epub 2017 Jun 10.
Our aim was to review the outcomes of endoscopic nasopharyngectomy performed on a large series of patients with residual or recurrent nasopharyngeal carcinomas and to identify the prognostic factors.
Ninety-one patients with residual (10) and recurrent (81) nasopharyngeal carcinomas who underwent endoscopic nasopharyngectomy were enrolled in our study. Clinical information including gender, age, medical history, symptoms, radiographic findings, tumor stage, treatment, recurrence time, postoperative pathological examination, complications, and outcomes at last follow-up visit was collected. The survival curves and multivariate survival analysis were analyzed using the Kaplan-Meier and Cox proportional hazards model.
Our study included 71 men and 20 women with a median age of 51 years. The lesions were staged as follows: rT1, 30; rT2, 13; rT3, 29; and rT4, 19. No serious operative or postoperative complication was observed. The median follow-up period was 23 months (range, 4-109 months). Tumor necrosis was identified in 40 of 91 patients. At the last follow-up, 42 patients were free of disease, 10 were alive with disease, and 39 had died. At 2- and 5-year follow-up, the overall survival rates were 64.8% and 38.3%, respectively; the disease-free survival rates were 57.5% and 30.2%, respectively, for the two periods. Multivariate analysis showed that T classification (P = 0.02) and tumor necrosis (P = 0.024) were independent risk factors.
Endoscopic nasopharyngectomy is a feasible and effective surgical treatment for recurrent and residual nasopharyngeal carcinomas.
我们的目的是回顾对大量残留或复发性鼻咽癌患者实施内镜下鼻咽切除术的结果，并确定预后因素。
91例接受内镜下鼻咽切除术的残留（10例）和复发性（81例）鼻咽癌患者纳入我们的研究。收集临床信息，包括性别、年龄、病史、症状、影像学检查结果、肿瘤分期、治疗情况、复发时间、术后病理检查、并发症以及最后一次随访时的结果。使用Kaplan-Meier法和Cox比例风险模型分析生存曲线和多因素生存分析。
我们的研究包括71名男性和20名女性，中位年龄为51岁。病变分期如下：rT1，30例；rT2，13例；rT3，29例；rT4，19例。未观察到严重的手术或术后并发症。中位随访期为23个月（范围4 - 109个月）。91例患者中有40例发现肿瘤坏死。在最后一次随访时，42例患者无疾病，10例患者带瘤生存，39例患者死亡。在2年和5年随访时，总生存率分别为64.8%和38.3%；两个时期的无病生存率分别为57.5%和30.2%。多因素分析显示T分类（P = 0.02）和肿瘤坏死（P = 0.024）是独立的危险因素。
内镜下鼻咽切除术是治疗复发性和残留性鼻咽癌的一种可行且有效的手术方法。
