%0 Journal Article
%T Surgical Management of Recurrent Nasopharyngeal Carcinoma
%A Sheng-Po Hao
%A Ngan-Ming Tsang
%J Chang Gung Medical Journal
%D 2010
%I 
%X Current standard treatment of nasopharyngeal carcinoma(NPC) is either radiotherapy alone or combined chemoradiotherapy.Surgery in the form of nasopharyngectomy is usuallyonly offered when there is evidence of local recurrence or persistentdisease. Recurrent NPC (rNPC) can be detected earlierwith the utilization of Epstein-Barr virus molecular diagnosis.This may result in early management with salvage surgery andhence improved survival. The facial translocation approachenhanced our ability to access the nasopharynx. Through amultidisciplinary approach with the collaboration of neurosurgeons,the surgical indication of salvage surgery is extended.This allowed improved respectability in locally advanced diseaseand involved the skull base and intracranial extensionwith reasonable morbidity and mortality. Endoscopic nasopharyngectomyis a choice for recurrent NPC with central roof orfloor lesions with minimal lateral extension. Multivariate analysis indicated that gender,parapharyngeal space involvement, surgical margin, and the modality of adjuvant therapyimpact significantly on local control. The impact on survival is indicated by the dura orbrain involvement, local recurrence and modality of adjuvant therapy. It is apparent thatrecurrent NPC patients who underwent surgery had a significantly better survival rate thanthe re-radiation therapy group.
%K nasopharyngeal carcinoma (NPC)
%K local recurrence
%K salvage surgery
%K skull base surgery
%K Epstein-Barr virus (EBV)
%K prognosis
%U http://memo.cgu.edu.tw/cgmj/3304/330402.pdf