RESECTION OF PERSISTENT NASOPHARYNGEAL CARCINOMA

Although radiotherapy has been generally accepted as the treatment of choice for nasopharyngeal carcinoma (NPC), NPC at the primary site is not always controlled by this therapy. We performed surgical treatment to eradicate such residual tumor through a transmandibular, transpter ygoid approach, on four patients with local residual NPC after curativ e radiotherapy. Two patients survived with no evidence of disease for more than 6 years. The other two patients died of multiple metastases to the liver or bone at 4 years and at 6 months after treatment. Howev er, the nasopharynx remained free of disease in these two patients. Al though the number of patients in the present series is small, surgical treatment of local persistent tumor after radiotherapy was beneficial . The indication for this technique is tumor in the nasopharynx extend ing to the parapharyngeal space, not invading intracranially. The tran smandibular, transpterygoid approach offers a wide operative field wit h minimal postoperative morbidity, making it possible to manage the in ternal carotid artery easily.