The efficacy and safety of salvage surgery for local recurrent nasopharyngeal carcinoma: a systematic review and Meta-analysis
10.3760/cma.j.issn.1673-0860.2019.09.006
- VernacularTitle: 复发鼻咽癌挽救性手术有效性与安全性的Meta分析
- Author:
Jianqi WANG
1
;
Ri HAN
2
;
Xiangping LI
2
;
Yunteng ZHAO
3
;
Xiaoxiao YU
3
;
Xianwen WANG
3
;
Ke WANG
3
;
Gang LI
2
Author Information
1. Department of Otorhinolaryngology Hend and Neck Surgery, the Third Affiliated Hospital of Southen Medical University, Guangzhou 510360, China
2. Department of Otorhinolaryngology Head and Neck Surgery, Southen Hospital Affiliated to Southen Medical University, Guangzhou 510515, China
3. Department of Clinical Medicine, Southen Medical University, Guangzhou 510515, China
- Publication Type:Journal Article
- Keywords:
Nasopharyngeal neoplasms;
Endoscopic surgery;
Salvage surgery;
Meta-analysis
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2019;54(9):676-684
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the current evidence regarding the efficacy, safety, and potential advantages of endoscopic compared with open salvage surgery for patients with local recurrent nasopharyngeal carcinoma.
Methods:A systematic search of Pubmed/Medline, Embase, and Cochrane databases ranged between 2000 and 2017 was conducted. Included studies reported specific residual or local recurrent nasopharyngeal cancer survival data. Proportional Meta-analysis was performed on both outcomes with a random-effects model and the 95% confidential intervals were calculated by Stata 12.0 software.
Results:A total of 24 case series studies were included in the Meta-analysis.The pooled 2-year overall survival rates of endoscopic and open group were 84% (95%CI:72%-93%), 68%(95%CI:59%-77%),respectively.The pooled 2-year disease-free survival rates of endoscopic and open group were 68%(95%CI:53%-81%), 65%(95%CI:54%-75%),respectively. The pooled 5-year overall survival rates of endoscopic and open group were 72%(95%CI:37%-97%), 48% (95%CI:40%-56%),respectively.The pooled 5-year disease-free survival rates of endoscopic and open group were 65%(95%CI:29%-93%), 50%(95%CI:43%-57%),respectively.The combined outcome of endoscopic was higher than open procedure. In addition, less severe complications, lower local recurrence rates(27%vs32%).The 2-year overall survival rates of endoscopic was higher than open procedure in the staging of rT1, rT2, and rT3 (93%vs87%; 77%vs63%; 67%vs53%) , but was equal to open in the staging for rT4 (35%vs35%) .Meta-regression showed that the heterogeneity was correlated with advanced tumor ratio.
Conclusions:The present Meta-analysis reveals that endoscopic approach offers a safe and efficient alternative to open approach with better short-term outcome and fewer postoperative complications in selecting patients strictly.
