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Published in: World Journal of Surgical Oncology 1/2016

Open Access 01-12-2016 | Research

Salvage surgery for neck residue or recurrence of nasopharyngeal carcinoma after primary radiotherapy: options of surgical methods and regions

Authors: Sheng-ye Wang, Jian-lin Lou, Jianxiang Chen, Su-zhan Zhang, Liang Guo

Published in: World Journal of Surgical Oncology | Issue 1/2016

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Abstract

Background

Salvage surgery has been recommended as the approach of choice for neck residue or recurrence of nasopharyngeal carcinoma (NPC) after primary radiotherapy (RT). This study aimed to assess the outcome and prognostic factors, options for different surgical methods, and the extent of neck dissection (ND) for patients.

Methods

NPC patients who had undergone RT and received salvage surgery for neck residue or recurrence from January 2001 to December 2011 were retrospectively analyzed. The overall survival (OS) rate was calculated by Kaplan-Meier method, and prognostic factors were determined by log-rank test and Cox regression analysis.

Results

In 153 cases, 96 cases have level I dissections. The metastasis rate was 20/153 (13.07 %) for level I metastasis and 7/153 (4.58 %) for parotid gland cases. The 3- and 5-year OS rate was 57.2 and 40.6 %, respectively, and median survival time was 49 months. By univariate analysis, the age, rN staging, size of lymph nodes (LN), extra-capsular spread (ECS), and surgical procedure were significant prognostic factors. By multivariable analysis, the age, rN staging, and size of LN were significant prognostic factors.

Conclusions

Salvage surgery is effective for neck failure of NPC after primary treatment, but patients with age >50 years, stage rN3, or LN >6 cm have poor prognosis.
Literature
2.
go back to reference Lin JC, Jan JS, Hsu CY, et al. Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival. J Clin Oncol. 2003;21:631–7.CrossRefPubMed Lin JC, Jan JS, Hsu CY, et al. Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival. J Clin Oncol. 2003;21:631–7.CrossRefPubMed
4.
go back to reference Wei WI, Chan JY, Ng RW, Ho WK. Surgical salvage of persistent or recurrent nasopharyngeal carcinoma with maxillary swing approach-critical appraisal after 2 decades. Head Neck. 2011;33:969–75.CrossRefPubMed Wei WI, Chan JY, Ng RW, Ho WK. Surgical salvage of persistent or recurrent nasopharyngeal carcinoma with maxillary swing approach-critical appraisal after 2 decades. Head Neck. 2011;33:969–75.CrossRefPubMed
5.
go back to reference Lee AW, Foo W, Law SC, et al. Nasopharyngeal carcinoma: presenting symptoms and duration before diagnosis. Hong Kong Med J. 1997;3:355–61.PubMed Lee AW, Foo W, Law SC, et al. Nasopharyngeal carcinoma: presenting symptoms and duration before diagnosis. Hong Kong Med J. 1997;3:355–61.PubMed
6.
go back to reference Spano JP, Busson P, Atlan D, et al. Nasopharyngeal carcinomas: an update. Eur J Cancer. 2003;39:2121–35.CrossRefPubMed Spano JP, Busson P, Atlan D, et al. Nasopharyngeal carcinomas: an update. Eur J Cancer. 2003;39:2121–35.CrossRefPubMed
7.
go back to reference Leung TW, Tung SY, Sze WK, et al. Treatment results of 1070 patients with nasopharyngeal carcinoma: an analysis of survival and failure patterns. Head Neck. 2005;27:555–65.CrossRefPubMed Leung TW, Tung SY, Sze WK, et al. Treatment results of 1070 patients with nasopharyngeal carcinoma: an analysis of survival and failure patterns. Head Neck. 2005;27:555–65.CrossRefPubMed
8.
go back to reference Wei WI, Lam KH, Ho CM, et al. Efficacy of radical neck dissection for the control of cervical metastasis after radiotherapy for nasopharyngeal carcinoma. Am J Surg. 1990;160:439–42.CrossRefPubMed Wei WI, Lam KH, Ho CM, et al. Efficacy of radical neck dissection for the control of cervical metastasis after radiotherapy for nasopharyngeal carcinoma. Am J Surg. 1990;160:439–42.CrossRefPubMed
9.
go back to reference Wei WI, Mok VW. The management of neck metastases in nasopharyngeal cancer. Curr Opin Otolaryngol Head Neck Surg. 2007;15:99–102.CrossRefPubMed Wei WI, Mok VW. The management of neck metastases in nasopharyngeal cancer. Curr Opin Otolaryngol Head Neck Surg. 2007;15:99–102.CrossRefPubMed
10.
go back to reference Yen KL, Hsu LP, Sheen TS, Chang YL, Hsu MH. Salvage neck dissection for cervical recurrence of nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 1997;123:725–9.CrossRefPubMed Yen KL, Hsu LP, Sheen TS, Chang YL, Hsu MH. Salvage neck dissection for cervical recurrence of nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 1997;123:725–9.CrossRefPubMed
11.
go back to reference Lin CY, Tsai ST, Jin YT, Yang MW, Yeh IC, Hsiao JR. Outcome of surgical management of persistent or recurrent neck mass in patients with nasopharyngeal carcinoma after radiotherapy. Eur Arch Otorhinolaryngol. 2008;265 Suppl 1:S69–74.CrossRefPubMed Lin CY, Tsai ST, Jin YT, Yang MW, Yeh IC, Hsiao JR. Outcome of surgical management of persistent or recurrent neck mass in patients with nasopharyngeal carcinoma after radiotherapy. Eur Arch Otorhinolaryngol. 2008;265 Suppl 1:S69–74.CrossRefPubMed
12.
go back to reference Greene FL, Page DL, Fleming ID, Fritz A, Balch CM, Haller DG, Morrow M. American Joint Committee on cancer staging manual. 6th ed. New York: Springer; 2002.CrossRef Greene FL, Page DL, Fleming ID, Fritz A, Balch CM, Haller DG, Morrow M. American Joint Committee on cancer staging manual. 6th ed. New York: Springer; 2002.CrossRef
13.
go back to reference Sham JST, Choy D. Nasopharyngeal carcinoma: treatment of neck node recurrence by radiotherapy. Australas Radiol. 1991;35:370–3.CrossRefPubMed Sham JST, Choy D. Nasopharyngeal carcinoma: treatment of neck node recurrence by radiotherapy. Australas Radiol. 1991;35:370–3.CrossRefPubMed
14.
go back to reference Zhang L, Zhu YX, Wang Y, Huang CP, Wu Y, Ji QH. Salvage surgery for neck residue or recurrence of nasopharyngeal carcinoma: a 10-year experience. Ann Surg Oncol. 2011;18:233–8.CrossRefPubMedPubMedCentral Zhang L, Zhu YX, Wang Y, Huang CP, Wu Y, Ji QH. Salvage surgery for neck residue or recurrence of nasopharyngeal carcinoma: a 10-year experience. Ann Surg Oncol. 2011;18:233–8.CrossRefPubMedPubMedCentral
15.
go back to reference Wei WI, Ho WK, Cheng AC, et al. Management of extensive cervical nodal metastasis in nasopharyngeal carcinoma after radiotherapy: a clinicopathological study. Arch Otolaryngol Head Neck Surg. 2001;127:1457–62.CrossRefPubMed Wei WI, Ho WK, Cheng AC, et al. Management of extensive cervical nodal metastasis in nasopharyngeal carcinoma after radiotherapy: a clinicopathological study. Arch Otolaryngol Head Neck Surg. 2001;127:1457–62.CrossRefPubMed
16.
17.
go back to reference Khafif A, Ferlito A, Takes RP, Thomas RK. Is it necessary to perform radical neck dissection as a salvage procedure for persistent or recurrent neck disease after chemoradiotherapy in patients with nasopharyngeal cancer? Eur Arch Otorhinolaryngol. 2010;267:997–9.CrossRefPubMedPubMedCentral Khafif A, Ferlito A, Takes RP, Thomas RK. Is it necessary to perform radical neck dissection as a salvage procedure for persistent or recurrent neck disease after chemoradiotherapy in patients with nasopharyngeal cancer? Eur Arch Otorhinolaryngol. 2010;267:997–9.CrossRefPubMedPubMedCentral
19.
go back to reference Sham JST, Choy D, Wei WI, et al. Nasoparyngeal carcinoma orderly neck node spread [J]. Int J Radiat Oncol Biol Phys. 1990;19(8):929–33.CrossRefPubMed Sham JST, Choy D, Wei WI, et al. Nasoparyngeal carcinoma orderly neck node spread [J]. Int J Radiat Oncol Biol Phys. 1990;19(8):929–33.CrossRefPubMed
Metadata
Title
Salvage surgery for neck residue or recurrence of nasopharyngeal carcinoma after primary radiotherapy: options of surgical methods and regions
Authors
Sheng-ye Wang
Jian-lin Lou
Jianxiang Chen
Su-zhan Zhang
Liang Guo
Publication date
01-12-2016
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2016
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-016-0822-8

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