Preliminary Efficacy Report and Prognosis Analysis of Endoscopic Endonasal Nasopharyngectomy for Recurrent Nasopharyngeal Carcinoma

Abstract

Background: Compared with radiotherapy, endoscopic endonasal nasopharyngectomy (EEN) is increasingly used to treat recurrent nasopharyngeal carcinoma (NPC) because of its good prognosis and mild complications. This study aims to investigate the efficacy of EEN in the treatment of recurrent NPC and factors affecting prognosis.Methods: This study included all patients who received EEN for recurrent nasopharyngeal carcinoma from April 2016 to April 2020. All operations were performed in Xiangya Hospital Central South University. The patient's 2-year overall survival (OS) rate, disease-free survival (DFS) rate and significant prognostic factors are reported.Results: There were 38 (67.9%) males and 28 (32.1%) females, with a median age of 43 (range, 24–69 years).43 (76.8%) of the patients in our study were in advanced rT3-rT4 stage and 32 (74.4%) of the patients in the advanced stage had tumor growth closely related to the internal carotid artery (ICA). During a mean follow up period of 44 month (range 1–65 months) post-surgery. The 2-year OS rate was 48.6%, 2-year DFS rate was 42.6%. The 2-year OS rates of rT1-2 and rT3-4 recurrent NPC were 83.9 and 35.6%, respectively. The 2-year DFS rates of rT1-2 and rT3-4 recurrent NPC 76.2 and 56.3%. The advanced T stage were associated with a poor prognosis in terms of OS and DFS.Conclusions: Data indicate that T staging may be an independent prognostic factor for OS and DFS. Through proper preoperative evaluation, EEN is an alternative treatment option for advanced recurrent NPC that ensures a certain level of efficacy and is relatively safe with few complications. However, additional studies with long-term follow-up and a larger sample size are required.

Salvage Endoscopic Skull Base Surgery: Another Treatment Option After Immunotherapy for Recurrent Nasopharyngeal Carcinoma

“…Salvage endoscopic skull base nasopharyngectomy as a surgical treatment has recently been increasingly used for simple recurrent NPC with or without cervical lymph node metastases. After undergoing surgical treatment, the 2-year DFS rate was 40.0%–92.8% and the 5-year OS rate was 38.3%–78.1% ( 1 , 3 , 25 – 27 ). These results indicate that surgical treatment plays an increasingly important role in the treatment of recurrent NPC.…”

“…Skull base surgery for recurrent NPC, also called salvage endoscopic skull base nasopharyngectomy, has played an important role in the treatment of advanced recurrent NPC ( 1 – 3 , 8 ). For patients with advanced recurrent NPC whose whole-body health status can tolerate surgery, the rT1–2 and rT3–4 2-year overall survival (OS) rates are 83.9% and 35.9%, respectively.…”

“…For patients with advanced recurrent NPC whose whole-body health status can tolerate surgery, the rT1–2 and rT3–4 2-year overall survival (OS) rates are 83.9% and 35.9%, respectively. The 2-year disease-free survival (DFS) rate is 42.6% ( 3 ). With the development of endoscopic techniques and increased familiarity of skull base surgeons with nasopharyngeal anatomy, surgery for patients with local recurrence with or without local metastasis may be another treatment option for patients with advanced recurrent NPC.…”

Advances of DNA Damage Repair-Related Drugs and Combination With Immunotherapy in Tumor Treatment

“…Consequently, a vain, repetitive repair cycle is initiated. Apparently, this is an obstacle to the subsequent DNA replication in S phase ( 13 ), and finally, it will cause DNA DSB ( 14 ) in MGMT- and MMR+ cancer cells. Although the detailed molecular mechanism has not been fully understood yet, many have verified that DSB produced by O6 MeG processing is lethal by triggering apoptosis.…”

N6-Methyladenosine RNA Modification Landscape in the Occurrence and Recurrence of Nasopharyngeal Carcinoma

“…With the development of treatment techniques, the 5-year overall survival rate of NPC has reached 50-64%. However, 10-20% of patients with NPC still experience locoregional recurrence, metastasis, invasion, and radio resistance [4][5][6]. Therefore, determining biomarkers and potential mechanisms affecting carcinogenesis and recurrence is essential for developing a more personalized treatment for patients with NPC.…”