Impact of resection margin status on outcome after salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma

Head Neck. 2016 Apr:38 Suppl 1:E594-9. doi: 10.1002/hed.24046. Epub 2015 Jul 6.

Abstract

Background: The purpose of this study was to present the postoperative local tumor control and survival with regard to the different resection margin statuses during salvage nasopharyngectomy.

Methods: We conducted a whole-organ study of nasopharyngectomy specimens.

Results: Between 2005 and 2010, 126 patients underwent maxillary swing nasopharyngectomy. The T classification of the recurrent tumor was: T1, 23.8%; T2, 41.3%; T3, 28.6%; and T4, 6.3%. The chance of clear, close, and involved resection margins at nasopharyngectomy was 44.4%, 31.0%, and 24.6%, respectively. At follow-up, the corresponding risk of local tumor recurrence after surgery was 10.7%, 38.5%, and 67.7%, respectively. The local tumor control was significantly worse in patients with involved margins compared with those with close margins (p = .01), which was, in turn, significantly worse than those with clear margins (p = .04).

Conclusion: The primary objective of salvage nasopharyngectomy is to achieve clear resection margins. Close and involved margins result in significantly inferior local tumor control and overall survival. © 2015 Wiley Periodicals, Inc. Head Neck 38: E594-E599, 2016.

Keywords: local recurrence; maxillary swing; recurrent nasopharyngeal carcinoma; resection margins; whole-organ study.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Margins of Excision*
  • Middle Aged
  • Nasopharyngeal Carcinoma
  • Nasopharyngeal Neoplasms / surgery*
  • Neoplasm Recurrence, Local / surgery*
  • Pharyngectomy
  • Retrospective Studies
  • Salvage Therapy*