Peng Zhouying, Wang Yumin, Wang Yaxuan, Fan Ruohao, Gao Kelei, Zhang Hua, Xie Zhihai, Jiang Weihong
Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.
Front Surg. 2021 Aug 30;8:713926. doi: 10.3389/fsurg.2021.713926. eCollection 2021.
Compared with radiotherapy, endoscopic endonasal nasopharyngectomy (EEN) is increasingly used to treat recurrent nasopharyngeal carcinoma (NPC) because of its good prognosis and mild complications. This study aims to investigate the efficacy of EEN in the treatment of recurrent NPC and factors affecting prognosis. This study included all patients who received EEN for recurrent nasopharyngeal carcinoma from April 2016 to April 2020. All operations were performed in Xiangya Hospital Central South University. The patient's 2-year overall survival (OS) rate, disease-free survival (DFS) rate and significant prognostic factors are reported. There were 38 (67.9%) males and 28 (32.1%) females, with a median age of 43 (range, 24-69 years).43 (76.8%) of the patients in our study were in advanced rT3-rT4 stage and 32 (74.4%) of the patients in the advanced stage had tumor growth closely related to the internal carotid artery (ICA). During a mean follow up period of 44 month (range 1-65 months) post-surgery. The 2-year OS rate was 48.6%, 2-year DFS rate was 42.6%. The 2-year OS rates of rT1-2 and rT3-4 recurrent NPC were 83.9 and 35.6%, respectively. The 2-year DFS rates of rT1-2 and rT3-4 recurrent NPC 76.2 and 56.3%. The advanced T stage were associated with a poor prognosis in terms of OS and DFS. Data indicate that T staging may be an independent prognostic factor for OS and DFS. Through proper preoperative evaluation, EEN is an alternative treatment option for advanced recurrent NPC that ensures a certain level of efficacy and is relatively safe with few complications. However, additional studies with long-term follow-up and a larger sample size are required.
与放射治疗相比，鼻内镜下经鼻鼻咽癌切除术（EEN）因其预后良好且并发症轻微，越来越多地用于治疗复发性鼻咽癌（NPC）。本研究旨在探讨EEN治疗复发性NPC的疗效及影响预后的因素。本研究纳入了2016年4月至2020年4月期间接受EEN治疗复发性鼻咽癌的所有患者。所有手术均在中南大学湘雅医院进行。报告了患者的2年总生存率（OS）、无病生存率（DFS）及重要的预后因素。男性38例（67.9%），女性28例（32.1%），中位年龄43岁（范围24 - 69岁）。本研究中43例（76.8%）患者处于rT3 - rT4晚期，其中32例（74.4%）晚期患者的肿瘤生长与颈内动脉（ICA）密切相关。术后平均随访44个月（范围1 - 65个月）。2年OS率为48.6%，2年DFS率为42.6%。rT1 - 2期和rT3 - 4期复发性NPC的2年OS率分别为83.9%和35.6%。rT1 - 2期和rT3 - 4期复发性NPC的2年DFS率分别为76.2%和56.3%。就OS和DFS而言，晚期T分期与预后不良相关。数据表明T分期可能是OS和DFS的独立预后因素。通过适当的术前评估，EEN是晚期复发性NPC的一种替代治疗选择，可确保一定的疗效水平，且相对安全，并发症较少。然而，需要进行更多长期随访和更大样本量的研究。
