内镜下鼻咽切除术治疗复发性或持续性鼻咽癌：香港某三级中心的10年结局

文献信息

中文摘要

目的： 分析香港某三级医院威尔士亲王医院（PWH）内镜下鼻咽切除术治疗复发性或持续性鼻咽癌（NPC）的结局。
方法： 对2015年至2025年间在PWH接受内镜下鼻咽切除术的患者进行回顾性分析。分析患者特征、疾病状态、手术并发症、切缘、是否需要辅助治疗、复发及生存结局。
结果： 本研究共纳入42例受试者，包括39例复发性NPC和3例持续性NPC。就疾病状态而言，33例为T1期疾病，5例为T2期疾病，4例为T3期疾病。仅1例患者发生术后出血并需要气管造口术，未发现其他重大并发症。25例患者实现切缘阴性，而5例患者切缘接近（<1mm），12例患者最终病理切缘阳性。5年总生存率为77%，5年无病生存率为60%。预后因素分析显示，手术切缘阴性的患者无病生存更好。对于切缘阳性或接近切缘的患者，术后辅助放疗在本队列中未提供生存获益。
结论： 在我们中心，内镜下鼻咽切除术治疗复发性或持续性NPC的并发症发生率低，生存结局与文献中其他中心相当。切缘状态是无病生存的重要预后因素。

英文摘要

AIM: To analyse the outcomes of endoscopic nasopharyngectomy for recurrent or persistent nasopharyngeal carcinoma (NPC) in Prince of Wales Hospital (PWH), a tertiary hospital in Hong Kong.
METHODS: A retrospective review on patients who underwent endoscopic nasopharyngectomy in PWH between 2015 to 2025. Patient characteristics, disease status, operative complications, resection margins, need for adjuvant treatment, recurrence and survival outcomes were analysed.
RESULTS: A total of 42 subjects, including 39 recurrent NPC and 3 persistent NPC, were recruited in this study. For disease status, 33 had T1 disease, 5 had T2 disease, and 4 had T3 disease. Only 1 patient had post-operative haemorrhage requiring tracheostomy with no other major complication noted. Negative margin was achieved in 25 patients, whilst 5 patients had close margin (<1mm) and 12 patients had positive margin in final pathology. The 5-year overall survival rate is 77% and 5-year disease-free survival rate is 60%. Prognostic factor analysis showed that patients with negative surgical margin had better disease-free survival. Postoperative adjuvant radiotherapy for positive or close margin did not provide survival benefits in this cohort.
CONCLUSION: Endoscopic nasopharyngectomy for recurrent or persistent NPC in our centre is of low complication rate, with comparable survival outcomes to other centres in the literature. Margin status is a significant prognostic factor for disease-free survival.