Chan Jimmy Yu Wai, Wong Stanley Thian Sze, Wei William Ignace
Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Li Ka Shing Faculty of Medicine, Queen Mary Hospital, Hong Kong SAR, China.
Head Neck. 2018 Jan;40(1):103-110. doi: 10.1002/hed.24976. Epub 2017 Oct 30.
The purpose of this study was to assess the predictability of the American Joint Committee on Cancer (AJCC) staging system on patients with stage II recurrent nasopharyngeal carcinoma (NPC).
We conducted a retrospective review of the surgical outcome for patients with recurrent NPC and retropharyngeal lymph node (RLN) metastasis (group I), recurrent NPC and parapharyngeal space (PPS) invasion (group II), and recurrent NPC and internal carotid artery (ICA) encasement (group III).
Between 1990 and 2013, 145 patients received an operation for stage II recurrent NPC (group I, n = 62; group II, n = 65; and group III, n = 18). The rate of local tumor recurrence was significantly higher in groups II and III. The rate of systemic metastasis was significantly higher in group III (16.7%). Accordingly, the 5-year overall survival was significantly worse for patients in group III (group I: 81.2%; group II: 68.4%; and group III: 48.5%).
The significantly worse prognosis of recurrent NPC encasing the ICA warrants an upstage to the T3 classification in the current AJCC staging system.
本研究旨在评估美国癌症联合委员会（AJCC）分期系统对II期复发性鼻咽癌（NPC）患者的预测能力。
我们对复发性NPC伴咽后淋巴结（RLN）转移患者（I组）、复发性NPC伴咽旁间隙（PPS）侵犯患者（II组）以及复发性NPC伴颈内动脉（ICA）包绕患者（III组）的手术结果进行了回顾性分析。
1990年至2013年间，145例患者接受了II期复发性NPC手术（I组，n = 62；II组，n = 65；III组，n = 18）。II组和III组的局部肿瘤复发率显著更高。III组的全身转移率显著更高（16.7%）。因此，III组患者的5年总生存率显著更差（I组：81.2%；II组：68.4%；III组：48.5%）。
在当前AJCC分期系统中，包绕ICA的复发性NPC预后显著更差，应将其分期提高至T3分类。
