Abstract

Nasopharyngeal tumors (NPT) are primarily treated with nonsurgical therapy. Recent studies have demonstrated endoscopic salvage surgery for NPT recurrences may improve survival relative to re-irradiation. However, there is very limited data on open compared to endoscopic approaches for NPT. We investigated whether endoscopic and open surgical approaches to the nasopharynx improve overall survival for all histologic subtypes of NPT.A retrospective cohort study using the National Cancer Database (NCDB) was performed. All adult patients with NPT from 2004 - 2016 without distant metastasis who underwent treatment with curative intent were included. We extracted clinical and treatment variables to assess our primary outcome of overall survival.On univariate analysis, patients undergoing endoscopic surgery but not open surgery had significantly improved overall survival relative to those undergoing nonsurgical treatment. Post hoc analysis demonstrated significantly improved overall survival for surgery in patients with minor salivary gland histology but not squamous cell carcinoma (SCC) histology or by T- or N-classification. A Cox proportional hazards model was used for multivariate regression. After adjusting for covariates, both endoscopic and open approaches were associated with improved overall survival relative to nonsurgical treatment for all tumor types. A multivariate regression of SCC found that open but not endoscopic surgery was significantly associated with improved overall survival.Both endoscopic and open surgical approaches are associated with improved overall survival of patients with NPT. These findings offer important oncologic validity as endoscopic and robotic platforms to the nasopharynx become more widely adopted. This article is protected by copyright. All rights reserved.

View details for DOI 10.1002/alr.23000

View details for PubMedID 35313077