THE CENTER FOR CRANIAL BASE SURGERY

Endoscopic Nasopharyngectomy

CT-Guided Endoscopic Resection for Recurrent Nasopharyngeal Cancer

The standard treatment of recurrent nasopharyngeal carcinoma (NPC) has been to re-irradiate or perform open nasopharyngectomy. Surgery can have better outcomes than radiation long term. Endoscopic nasopharyngectomy can have better survival than re-irradiation with potentially lower morbidity than open approaches. We review our series of endoscopic CT-guided nasopharyngectomies in the treatment of recurrent NPC.

We performed a retrospective review of 13 patients who presented to us with a recurrence of NPC after having chemotherapy and/or radiation treatment. All patients had endoscopic CT-guided nasopharyngectomy and were followed with repeat PET scans, MRIs and/or biopsies. Only 5 patients had complete records, and were used for analysis.

There were a total 3 male and 2 female patients with an average age of 44 years. All 5 patients are currently alive. 1 patient had a complication of epistaxis which required endoscopic control and embolization. There was 1 intra-operative CSF leak that was repaired without post-op complications. 3 patients had a recurrence of their cancer which required further intervention. The average time of disease free survival after the first surgery was 13.2 (range 9-18) months. The average time of overall survival after the first surgery was 16.4 (range 9-25) months. The average time of overall survival since date of diagnosis was 41.2 (range 22-58) months.

Endoscopic CT-guided Nasopharyngectomy is a safe and effective way of treating the recurrence of nasopharyngeal cancers in patients with prior failed chemotherapy and radiation. Further studies are warranted to compare this treatment modality with those previously described.

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