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Endoscopic nasopharyngectomy offers similar outcome compared to open surgery in the primary treatment of recurrent nasopharyngeal carcinoma without the functional and cosmetic morbidity. In this case series, we report the survival outcomes of seven recurrent nasopharyngeal carcinoma treated primarily with endoscopic nasopharyngectomy.
Retrospective review of patients who were diagnosed with locally recurrent nasopharyngeal carcinoma and underwent endoscopic nasopharyngectomy from year 2010 to 2018. The extent of nasopharyngectomy was categorized and the patients were followed up to assess the survival outcome.
Four patients had rT1 disease and had Type I nasopharyngeal endoscopic resection, one rT2 disease who had type 3 nasopharyngeal endoscopic resection, one rT3 that had type 2 nasopharyngeal endoscopic resection and one rT4 disease that had type 1 nasopharyngeal endoscopic resection and post-operative chemotherapy. The 2-year overall survival was 100% and disease-free survival was 85.71% for all stages. Only 25% of rT1 disease had post-nasopharyngectomy recurrence and the disease-free survival time was 25 months, whereas both rT2 and rT3 cases had recurrence 18 and 35 months post-operation respectively. However the rT4 case that received post-operative chemotherapy had no recurrence 47 months post nasopharyngectomy.
It is recommended that single modality treatment with endoscopic nasopharyngectomy is a good option for rT1 disease. However for rT2 disease and above, multi-modality treatment needs to be considered.