Management of nasopharyngeal carcinoma by surgery

Abstract

The main role of surgeons in the management of nasopharyngeal carcinoma is to provide salvage treatment for the tumour that recurs or persists after radiotherapy, either in the neck or at the primary site. In view of the extensive nature of the metastatic tumour in cervical lymph nodes, as shown by step-serial section studies of operative specimens, radical neck dissection is the operation of choice for salvage. The tumour control rate in the neck following surgery is 66% with 5-year actuarial survival rate of 38%. When recurrent or residual tumour at the primary site is small, then split palate implantation of radioactive gold grains as a brachytherapy source can achieve a local control rate of 80%. When tumour in the nasopharynx is more extensive, then surgical resection with the antereolateral approach can achieve local control in 52% and a 5-year survival rate of 43%.