Approximately 52 percent of patients with recurrent nasopharyngeal cancer survive overall, disease-free, for five years, a follow-up study indicates.
Local control at five years is 67 percent, United States researchers report and investigators at Stanford University in Palo Alto, California also say they found the five-year actuarial survival rate to be 60 percent.
The investigators followed 37 patients with biopsy-proven, recurrent nasopharyngeal cancer. Patients were treated at the same medical centre between May 1984 and the end of March 1999. Mean follow-up was 5.4 years.
The researchers concluded: "Surgical resection offers an advantage over additional irradiation for rT1 and rT2 tumours, but newer modalities of radiation therapy (XRT) offer great promise."
They suggest patients with rT3 tumours should be treated either with surgery plus postoperative XRT or with XRT alone. "Since many of these patients with rT3 disease develop distant metastases, consideration should be given to administering chemotherapy," investigators say. "Surgery would not seem to benefit patients with rT4 tumours, except for palliation."
A total of 24 men and 13 women made up the study group; average age at the time of surgery was 49 years. The study patients were classified as recurrent T-stage 1 (rT1) patients, five as rT2 patients, seven as rT3 patients and three as rT4 patients. They based classification on the Cancer Staging Manual.
Clinical examination, magnetic resonance imaging, chest x-ray examination and liver function tests were used to track recurrence during a minimum of two years of follow-up.
The investigators report survival for recurrent rT1 patients was 73 percent, 40 percent for rT2 patients, 14 percent for rT3 patients and 0 percent for rT4 patients.