Salvage surgery for locally recurrent nasopharyngeal carcinoma-A 10-year experience.

OBJECTIVE: To evaluate the result of salvage surgery for patients with primary recurrence of nasopharyngeal carcinoma (NPC) after radiation therapy. STUDY DESIGN AND SETTING: Prospective cohort at a tertiary referral center. PATIENTS AND METHODS: Thirty-eight consecutive patients with primary recurrence of NPC after radiation failure underwent salvage surgery for curative intention via the facial translocation approach from July 1993 to December 2002. The follow-up time ranged from 2 to 88 months. Twelve patients with intracranial and skull base invasion needed a combined neurosurgical approach. Eight patients had additional postoperative radiation therapy. RESULTS: The actuarial 3-year survival and local control rate was 60% and 72.8%, respectively. Ten (83.3%) of 12 patients with intracranial and skull base invasion achieved local control. There was no surgical mortality, and the morbidity rate was only 13.2%. CONCLUSION AND SIGNIFICANCE: The results of this study reveal better outcome of salvage surgery than that of most published literature of reirradiation for recurrent NPC. With the adequate exposure provided by the facial translocation approach, an integrated concept of skull base surgery, and the collaboration of neurosurgeons, we can extend our surgical indications of salvage surgery and resect many advanced lesions with acceptable mortality and morbidity.