SALVAGE SURGERY FOR RECURRENT NASOPHARYNGEAL CARCINOMA

Objective: To assess the efficacy of salvage surgery for patients with recurrent nasopharyngeal carcinoma (NPC) at the primary site after ra diotherapy. Design: Retrospective analysis of 24 patients treated by t ranspalatal, transmaxillary, or transmandibular approach to resect the recurrent tumor, with maximum follow-up of 50 months. Setting: Academ ic tertiary referral center. Results: Radiotherapy before salvage surg ery included 1 to 3 courses of radiation to the nasopharynx, with dose s ranging from 60 to 190 Gy. Eighteen (75%) of the patients relapsed w ithin 2 years, and 6 (25%) relapsed more than 6 years after the last i rradiation. In 4 of 6 late relapsing cases, the histopathological type changed to keratinizing squamous cell carcinoma, which is rare in cas es of NPC in Taiwan. Fourteen patients (58%) survived for 8 to 50 mont hs after surgery (median, 18 months). The surgical complications were tolerable. Conclusions: Salvage surgery is feasible in selected patien ts with recurrent disease at the primary site. Thus, we can offer alte rnative retreatment in addition to external irradiation for patients w ith recurrent NPC.