Different Surgical Procedures In Treatment Of Recurrent And Persistent Lymph Nodes Of Nasopharyngeal Carcinoma After Radiotherapy

ObjectiveTo compare the effectiveness of different surgical methods procedure for the patients ofnasopharyngeal carcinoma with recurrent and persistent lymph nodes after radiotherapy.MethodsThe clinical data of102patients of nasopharyngeal carcinoma with recurrent andpersistent lymph nodes after radiotherapy were analyzed retrospectively. Radical neckdissection (RND) were performed in38cases，modified radical neck dissection (MRND) in12cases, selective neck dissection (SND) in26cases, and lymph node resection (LNR) in26cases. The levels of involved lymph nodes and the relationship among the levels wereanalyzed. We compared the efficacy of4different surgical methods and evaluated the roleof postoperative radiotherapy.Results(1)102cases of patients with5-year survival rate was42.22%, lymph node recurrence ratewas24.5%.(2) Patients with lymph nodes involved in level III and IV, usually, have other levelsinvolved simultaneously. However, the lymph nodes in level II and V were mainly isolated.(3) The5-year survival rate and recur-rent rate of the whole group were42.22%and24.5%,respectively.(4) The5-year survival rates of RND, MRND, SND, and LMR groups were38.8%、59.2%、37.1%,and43.7%, respectively; the differences were insignificant (Log-rank=1.0,P=0.8023); the recurrent rate between the extensive and local surgery groups were insignificant (χ2=0.460, P=0.482).(5)The5-year survival rates of the patients with and without postoperative radiotherapywere39.06%and45.26%, respectively; the difference was insignificant (Log-rank=0.06, P=0.8213).ConclusionThe extensive surgery was recommended when the recurrent and persistent lymphnodes were more than one level involved or very large or immovable, otherwise, the SNDshould be performed and postoperative radiotherapy was important compensation ifnecessary.