Salvage surgery for nasopharyngeal carcinoma

Nasopharyngeal carcinoma is not a disease to be treated primarily by surgery. Radiation is the first choice of treatment. But, once it recurs, a second course of radiation controls only a small portion of the patients, with a high risk of accumulated radiation injury. We discuss the outcome of salvage surgery in nine cases of nasopharyngeal recurrence and 69 cases of neck metastasis that was uncontrolled or had recurred after irradiation was evaluated. A five-year survival rate of 44% for the primary lesions and 49% for the neck node metastases justifies the rationale of surgery on selected cases of radiation failure.