Salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma in a non-endemic area.

EBV Endoscopic nasopharyngectomy Head and neck oncology Nasopharyngeal carcinoma Skull base

Journal

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937

Informations de publication

Date de publication:
14 Mar 2024
Historique:
received: 08 12 2023
accepted: 23 01 2024
medline: 14 3 2024
pubmed: 14 3 2024
entrez: 14 3 2024
Statut: aheadofprint

Résumé

To analyze oncological outcomes of endoscopic surgical treatment of locally recurrent EBV-related undifferentiated non-keratinizing nasopharyngeal carcinoma (uNK-NPC) in a non-endemic area. Retrospective review of patients affected by recurrent uNK-NPC treated with nasopharyngeal endoscopic resection (NER) in a tertiary-care referral center from 2003 to 2022, by evaluating survival rates, prognostic factors, and follow-up strategies. The oncological outcomes of 41 patients were analyzed, over a mean follow-up period of 57 months. The 5-year overall, disease-specific, and disease-free survival of the cohort were 60.7% ± 8.9%, 69% ± 9%, and 39.7% ± 9.2%, respectively. The local (rT) and regional (rN) extension of recurrent disease, stage of disease, and status of resection margins appeared to significantly influence survivals. After a mean follow-up period of 21 months, a further recurrence after NER was observed in 36.6% of cases. Skull base osteonecrosis induced by previous irradiation and post-surgical bone remodeling represent the major challenges for early detection of further local relapses during postoperative follow-up. NER appeared as a safe and effective treatment for recurrent uNK-NPC. The adequate selection of patients eligible for NER is essential, to maximize the chances to cure and minimize the risk of local complications.

Identifiants

DOI: 10.1007/s00405-024-08500-8 PMID: 38480535
pubmed: 38480535
doi: 10.1007/s00405-024-08500-8
pii: 10.1007/s00405-024-08500-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

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Auteurs

Marco Valentini (M)

Department of Otolaryngology Head and Neck Surgery, Department of Biotechnology and Life Sciences, ASST Lariana, Ospedale Sant'Anna, University of Insubria, 22042, Como, San Fermo Della Battaglia, Italy. mvlntn92@gmail.com.
Head and Neck Surgery and Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, 21100, Varese, Italy. mvlntn92@gmail.com.
ORCID: 0000-0002-8708-8716

Alessia Lambertoni (A)

Department of Otorhinolaryngology Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, 21100, Varese, Italy.

Giorgio Sileo (G)

Department of Otorhinolaryngology Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, 21100, Varese, Italy.

Alberto Daniele Arosio (AD)

Department of Otorhinolaryngology Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, 21100, Varese, Italy.

Gianluca Dalfino (G)

Department of Otorhinolaryngology Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, 21100, Varese, Italy.

Fabio Pedretti (F)

Department of Otolaryngology, University of Pavia, 27100, Pavia, Italy.

Apostolos Karligkiotis (A)

Department of Otorhinolaryngology Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, 21100, Varese, Italy.

Maurizio Bignami (M)

Department of Otorhinolaryngology Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, 21100, Varese, Italy.
Head and Neck Surgery and Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, 21100, Varese, Italy.

Paolo Battaglia (P)

Department of Otolaryngology Head and Neck Surgery, Department of Biotechnology and Life Sciences, ASST Lariana, Ospedale Sant'Anna, University of Insubria, 22042, Como, San Fermo Della Battaglia, Italy.
Head and Neck Surgery and Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, 21100, Varese, Italy.

Paolo Castelnuovo (P)

Department of Otorhinolaryngology Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, 21100, Varese, Italy.
Head and Neck Surgery and Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, 21100, Varese, Italy.

Mario Turri-Zanoni (M)

Department of Otolaryngology Head and Neck Surgery, Department of Biotechnology and Life Sciences, ASST Lariana, Ospedale Sant'Anna, University of Insubria, 22042, Como, San Fermo Della Battaglia, Italy.
Head and Neck Surgery and Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, 21100, Varese, Italy.

Classifications MeSH