[Clinical efficacy of endoscopic nasopharyngectomy for initially diagnosed advanced nasopharyngeal carcinoma].

Objective: To explore the clinical efficacy in patients who underwent endoscopic nasopharyngectomy for primary advanced nasopharyngeal carcinoma (NPC). Methods: Forty-five patients who underwent endoscopic nasopharyngectomy for primary advanced NPC encountered between Aug. 2007 and Sep. 2015 were retrospectively reviewed. Twenty-seven patients were male (60.0%), and 18 patients were female (40.0%), the ratio of male to female was 3ratio2. The median age was 53 years old (ranged from 13 to 75 years old). The median onset time was 5 months (ranged from 1 to 72 months). TNM stage: 16 cases were at stage Ⅲ (35.6%), 29 at stage Ⅳ (64.4%); T3 16 cases (35.6%), T4 29 cases (64.4%); N0 38 cases (84.4%), N2 7 cases (15.6%). No patients were found to have distance metastasis. All patients underwent endoscopic resection of lesions. Postoperatively all the patients were treated with radiotherapy or chemoradiotherapy. Using SPSS 19.0 software, Kaplan-Meier and Log-rank test were done for the assessmen of survival rate; Cox proportional hazards model was used for the univariate analysis of prognostic factors. Results: The median follow-up was 36 months (ranged from 6 to 97 months), with 36 cases surviving (80.0%), 9 cases died (20.0%); 15 cases relapsed (33.3%). The overall 1 year survival rates (SR), 3 year SR, 5 year SR was 90.6%, 81.0%, 76.0%, respectively. The survival univariate analysis indicated the recurrence and metastasis were correlated with the survival (chi(2) value was 16.644, 6.451, respectively, all P<0.05). Conclusion: The patients who undergo endoscopic nasopharyngectomy for primary advanced NPC have better survival rate with lower recurrent rate and metastatic rate.