Surgical salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma: a multivariate analysis of prognostic factors.

Background The purpose of this study was to identify independent prognostic factors that influenced local relapse-free survival (LRFS) and overall survival (OS) of patients who underwent salvage surgery for residual or recurrent nasopharyngeal carcinoma (NPC). Methods Ninety-seven patients who had been treated with radiotherapy or chemoradiotherapy for NPC underwent a nasopharyngectomy for a residual or recurrent local tumor between November 1987 and June 2007. The subsequent minimum follow-up was 2 years. Univariate and multivariate analyses were performed to identify prognostic factors for LRFS and OS. Results The 5-year LRFS and OS was 46.7% and 51.9%, respectively. On multivariate analysis for LRFS and OS, respectively, recurrent regional disease (hazard ratio [HR], 3.245; p = .008) and (HR, 4.990; p = .001), and positive surgical margins (HR, 5.963; p = .000), and (HR, 4.912; p = .000) were independent prognostic factors. Conclusion In patients undergoing surgical salvage nasopharyngectomy for residual or recurrent NPC, positive surgical margins have an independent negative influence on LRFS and OS. © 2010 Wiley Periodicals, Inc. Head Neck, 2011