Salvage nasopharyngectomy for radiation recurrences

Abstract

Salvage nasopharyngectomy has proven to be worthwhile in the management of persistent or recurrent nasopharyngeal cancer after radiotherapy failure; however, surgical complications are common and the indications for surgery and the choice of operation remain controversial. Over a 17-year period from 1985 to 2001 salvage nasopharyngectomy was undertaken on 11 patients. In six patients an anterolateral disassembly approach was employed and five patients were treated with the more limited maxillary swing approach. In seven patients the nasopharynx was reconstructed with a revascularized forearm free graft. Six patients remain alive and free of disease with a minimum follow up of 4 years. There were no incidences of serious postoperative complications. The five patients who failed all did so locally. Nasopharyngectomy is safe and effective in the treatment of recurrent nasopharyngeal cancer even after multiple courses of radiotherapy.