Impact of Clinical Surveillance on Outcomes of Locally Recurrent Nasopharyngeal Carcinoma
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.
Conflicts of Interest
The authors declare no conflicts of interest.
This study was approved by the SingHealth Centralized Institutional Review Board, and approval for waiver of consent was obtained.
Open Research
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
