Impact of Clinical Surveillance on Outcomes of Locally Recurrent Nasopharyngeal Carcinoma.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-01-20 DOI:10.1002/hed.28060

Tsinrong Lee, Kiattisa Sommat, Isabelle Jang, Chwee Ming Lim, Fu Qiang Wang, Yoke Lim Soong, Joseph Wee, Terence Tan, Kam Weng Fong, Melvin Lee Kiang Chua, Sharon Poh, Kimberley Kiong

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Abstract

Background: Local recurrence of nasopharyngeal carcinoma (NPC) occurs in 10%-20% of patients, with salvage potential in early recurrences. Yet, clear surveillance protocols are lacking. We compare survival outcomes and suitability for salvage in symptomatic and incidentally detected locally recurrent NPC.

Methods: Locally recurrent NPC patients, initially diagnosed at the National Cancer Center Singapore between October 2003 and November 2009, were identified. Demographics, symptoms, detection modalities, and survival outcomes were analyzed.

Results: Eighty-two patients were studied. Median follow up and time to local recurrence was 5.51 and 2.19 years; 45.1% were symptomatic; 65.9% were diagnosed incidentally; 62.2% were offered salvage treatment. Symptomatic patients (vs. asymptomatic) had lower 5-year overall-survival (39.1% vs. 74.5%, p = 0.011). Nonincidental diagnoses (vs. incidental) had lower 5-year overall-survival (33.6% vs. 71.1%, p = 0.02). Incidentally-detected recurrences (vs. nonincidental) were more likely offered salvage treatment (75.9% vs. 35.7%, p < 0.001).

Conclusion: Routine clinical examination, nasoendoscopy, and imaging allow early detection of asymptomatic recurrences, with improved outcomes.

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临床监测对局部复发鼻咽癌预后的影响。

背景：鼻咽癌（NPC）局部复发发生率为10%-20%，早期复发具有挽救潜力。然而，缺乏明确的监控协议。我们比较了有症状和偶然发现的局部复发鼻咽癌患者的生存结果和抢救的适宜性。方法：对2003年10月至2009年11月在新加坡国家癌症中心首次诊断的局部复发的鼻咽癌患者进行鉴定。分析了人口统计学、症状、检测方式和生存结果。结果：对82例患者进行了研究。中位随访时间为5.51年，局部复发时间为2.19年；45.1%有症状；65.9%为偶然诊断；62.2%接受救助治疗。有症状患者（与无症状患者相比）的5年总生存率较低（39.1%比74.5%,p = 0.011）。非偶然诊断（与偶然诊断相比）的5年总生存率较低（33.6%对71.1%,p = 0.02）。偶然发现的复发（与非偶然发现的相比）更有可能接受挽救性治疗（75.9% vs. 35.7%）。结论：常规临床检查、鼻内窥镜检查和影像学检查可以早期发现无症状复发，改善预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.

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