Analysis Of Efficacy Of Endoscopic Surgery Using Plasma Knife For Recurrent Nasopharyngeal Carcinoma

Objective To explore the efficacy of patients who underwent endoscopic surgery using plasma knife for recurrent nasopharyngeal carcinoma(NPC),and to analyze its influence on prognostic indicators including local control rate and survival rate,etc.Summarize the advantages and disadvantages and guide clinicians to make a better treatment for recurrent nasopharyngeal carcinoma.Methods 24 patients with pathetically proved in the Union Hospital afflicted of Fujian Medical University were retrospectively reviewed between January 2013 and February 2018.All patients were received endoscopic nasopharyngectomy with plasma knife,and one case with cervical metastasis received neck dissection at the same time.Besides that,6 cases were taken chemotherapy after the surgery.Following up the cases through the outpatient clinic visits,contact with them by telephone or other way after the surgery.There is no one lost to follow-up in these patients.We record the sex and the age of the patients,clinical performance while visiting,relapse time interval,recurrent TNM stage,pathological types,the postoperative hospitalization days,their servival statement,etc,to analyse the efficacy afer endoscopic nasopharyngectomy using plasma knife for recurrent NPC and come to the conclusion.Results Of 24 patients,13 were male and 11 were female,with a median age of 46 years(range26-67).The median relapse time interval was 43months(range 6-192months).TheT classification of the recurrent tumor was: rT1,15 cases;rT2,4 cases;rT3,5 cases;and rT4 0case.Of the pathological types,19 cases were non-keratinized undifferentiated carcinoma and 5 cases were squamous cell carcinoma.The mean postoperative hospitalization day is 6.92.The median follow-up period was 22months(range3-55months).The 1 year survival rate and the tumor free survival rate were 100%.The 2 year survival rate and the disease-free survival rate were 92.8% and 85.7%respectively.Conclusion Endoscopic nasopharyngectomy surgery is a effective treatment for relapse after radiotherapy and chemotherapy.Secondly,assistedsurgery is the most minimally invasive method for salvage surgery of nasopharyngeal carcinoma,with the advantages of less injury,less bleeding,quicker recovery and fewer complications.