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Published on: August 15, 2025
Endoscopic surgery for early-stage nasopharyngeal carcinoma: a justified initial option
Yan Huang1, Qian-Hui Qiu1,2
1a Department of Otolaryngology , Guangdong General Hospital and Guangdong Academy of Medical Sciences , Guangzhou , China.
Objectives:
To assess the prognosis of initial endoscopic surgery in T1N0M0 and T2N0M0 staged NPC patients.
Materials And Methods:
Between 2002 and 2016, 10 previously untreated patients with T1N0M0 or T2N0M0 staged NPC volunteered to receive endoscopic surgery followed by four courses of TPF chemotherapy. EORTC QLQ-C30 and QLQ-H&N35 were used to evaluate the QOL after treatment.
Results:
With the median follow-up of 30 months (range, 9 months to 128 months), the 24-month survival rate was 100% (6/6), 90% (9/10) patients were still alive and well, 20% (2/10) patients reported tumor recurrence. One died of the disease at 128 months with nasopharyngeal recurrence. Another patient who refused preoperative PET-CT had a cervical recurrence at nine months, accepted nasopharynx and neck radiation two months later and was still alive and well at 50 months. In the post-treatment questionnaires, several NPC-specific (pain, swallowing, speech, social eating, opening mouth, dry mouth, sticky saliva) QOL domains were better preserved compared with radiotherapy alone or combined chemoradiotherapy in other surveys.
Conclusions:
Initial endoscopic surgery combined with chemotherapy maybe justified in the hands of highly experienced surgeon in selected early-stage NPC cases and can improve their QOL. In addition, preoperative PET-CT should be included in case of possible minimal metastases.
