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Statements 2008 on Head Neck Cancer Frankfurt Germany 1 -2 February 2008. Discussion Panel: Nasopharynx Surgical Salvage of recurrent Nasopharyngeal Cancer. Recurrent Nasopharyngeal Ca. Small tumour, optimal location brachytherapy: gold grain implant Localized tumour, not affecting
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Statements 2008 on Head Neck Cancer Frankfurt Germany 1 -2 February 2008 Discussion Panel: Nasopharynx Surgical Salvage of recurrent Nasopharyngeal Cancer
Recurrent Nasopharyngeal Ca • Small tumour, optimal location brachytherapy: gold grain implant • Localized tumour, not affecting carotid art or skull base surgical resection: maxillary swing approach
Results (n = 212) • 1989 – 2006 curative resection 164 palliative resection 48 hospital mortality 0 morbidity - trismus 45 • median follow up 30 months • 5-year actuarial local tumour control 67% • 5-year disease free survival 52% carotid art infiltration affected disease free survival (p = 0.005)
Detection of recurrence • Clinical & endoscopic exam + Bx macroscopical tumour • CT - soft tissue, bone erosion • MRI - irregular tissue with progression • PET -critical tumour volume • EBVirus DNA - tumour volume +ve in 67% of surgical salvage curative resection reduces DNA copies Wei WI et al Head Neck. 2004; 26:878-83