A 4-year review of surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy in salvaging locally recurrent nasopharyngeal carcinoma

Purpose: To study the surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy (EETN) in salvaging locally recurrent nasopharyngeal carcinoma (NPC). Method: This was a retrospective clinical record review study carried out at a tertiary centre from June 2013 until M...

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Main Authors: Tang, Ing Ping, Ngui, Ling Xiu, Ramachandran, Komathi, Lim, Li Yun, Voon, Pei Jye, Yu, Kong Leong, Narayanan, Prepageran, Carrau, Ricardo
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Published: Springer 2019
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Online Access:http://eprints.um.edu.my/23281/
https://doi.org/10.1007/s00405-019-05522-5
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spelling my.um.eprints.232812019-12-23T03:14:53Z http://eprints.um.edu.my/23281/ A 4-year review of surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy in salvaging locally recurrent nasopharyngeal carcinoma Tang, Ing Ping Ngui, Ling Xiu Ramachandran, Komathi Lim, Li Yun Voon, Pei Jye Yu, Kong Leong Narayanan, Prepageran Carrau, Ricardo R Medicine Purpose: To study the surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy (EETN) in salvaging locally recurrent nasopharyngeal carcinoma (NPC). Method: This was a retrospective clinical record review study carried out at a tertiary centre from June 2013 until May 2017. A total of 55 locally recurrent NPC patients (rT1–rT4) underwent EETN performed by single skull base surgeon with curative intention with postoperative adjuvant chemotherapy but without postoperative radiotherapy. Results: There were 44 (80.0%) males and 11 (20.0%) females, with mean age of 52.5 years. The mean operating time was 180 min (range 150–280 min). 85% (47/55) of patients achieved en bloc tumour resection. 93% (51/55) of patients obtained negative microscopic margin based on postoperative histopathological evaluation. Intraoperatively, one (1.8%) patient had internal carotid artery injury which was successfully stented and had recovered fully without neurological deficit. There were no major postoperative complications reported. During a mean follow-up period of 18-month (range 12–48 months) postsurgery, five patients (9.1%) had residual or recurrence at the primary site. All five patients underwent re-surgery. One patient at rT3 passed away 6 months after re-surgery due to distant metastasis complicated with septicaemia. The 1-year local disease-free rate was 93% and the 1-year overall survival rate was 98%. Conclusions: EETN is emerging treatment options for locally recurrent NPC, with relatively low morbidity and encouraging short-term outcome. Long-term outcome is yet to be determined with longer follow-up and bigger cohort study. However, a successful surgical outcome required a very experienced team and highly specialised equipment. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Springer 2019 Article PeerReviewed Tang, Ing Ping and Ngui, Ling Xiu and Ramachandran, Komathi and Lim, Li Yun and Voon, Pei Jye and Yu, Kong Leong and Narayanan, Prepageran and Carrau, Ricardo (2019) A 4-year review of surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy in salvaging locally recurrent nasopharyngeal carcinoma. European Archives of Oto-Rhino-Laryngology, 276 (9). pp. 2475-2482. ISSN 0937-4477 https://doi.org/10.1007/s00405-019-05522-5 doi:10.1007/s00405-019-05522-5
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
spellingShingle R Medicine
Tang, Ing Ping
Ngui, Ling Xiu
Ramachandran, Komathi
Lim, Li Yun
Voon, Pei Jye
Yu, Kong Leong
Narayanan, Prepageran
Carrau, Ricardo
A 4-year review of surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy in salvaging locally recurrent nasopharyngeal carcinoma
description Purpose: To study the surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy (EETN) in salvaging locally recurrent nasopharyngeal carcinoma (NPC). Method: This was a retrospective clinical record review study carried out at a tertiary centre from June 2013 until May 2017. A total of 55 locally recurrent NPC patients (rT1–rT4) underwent EETN performed by single skull base surgeon with curative intention with postoperative adjuvant chemotherapy but without postoperative radiotherapy. Results: There were 44 (80.0%) males and 11 (20.0%) females, with mean age of 52.5 years. The mean operating time was 180 min (range 150–280 min). 85% (47/55) of patients achieved en bloc tumour resection. 93% (51/55) of patients obtained negative microscopic margin based on postoperative histopathological evaluation. Intraoperatively, one (1.8%) patient had internal carotid artery injury which was successfully stented and had recovered fully without neurological deficit. There were no major postoperative complications reported. During a mean follow-up period of 18-month (range 12–48 months) postsurgery, five patients (9.1%) had residual or recurrence at the primary site. All five patients underwent re-surgery. One patient at rT3 passed away 6 months after re-surgery due to distant metastasis complicated with septicaemia. The 1-year local disease-free rate was 93% and the 1-year overall survival rate was 98%. Conclusions: EETN is emerging treatment options for locally recurrent NPC, with relatively low morbidity and encouraging short-term outcome. Long-term outcome is yet to be determined with longer follow-up and bigger cohort study. However, a successful surgical outcome required a very experienced team and highly specialised equipment. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
format Article
author Tang, Ing Ping
Ngui, Ling Xiu
Ramachandran, Komathi
Lim, Li Yun
Voon, Pei Jye
Yu, Kong Leong
Narayanan, Prepageran
Carrau, Ricardo
author_facet Tang, Ing Ping
Ngui, Ling Xiu
Ramachandran, Komathi
Lim, Li Yun
Voon, Pei Jye
Yu, Kong Leong
Narayanan, Prepageran
Carrau, Ricardo
author_sort Tang, Ing Ping
title A 4-year review of surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy in salvaging locally recurrent nasopharyngeal carcinoma
title_short A 4-year review of surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy in salvaging locally recurrent nasopharyngeal carcinoma
title_full A 4-year review of surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy in salvaging locally recurrent nasopharyngeal carcinoma
title_fullStr A 4-year review of surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy in salvaging locally recurrent nasopharyngeal carcinoma
title_full_unstemmed A 4-year review of surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy in salvaging locally recurrent nasopharyngeal carcinoma
title_sort 4-year review of surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy in salvaging locally recurrent nasopharyngeal carcinoma
publisher Springer
publishDate 2019
url http://eprints.um.edu.my/23281/
https://doi.org/10.1007/s00405-019-05522-5
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