Endoscopic nasopharyngectomy for recurrent or persistent nasopharyngeal carcinoma: a 10-year outcome from a tertiary centre in Hong Kong.

AIM: To analyse the outcomes of endoscopic nasopharyngectomy for recurrent or persistent nasopharyngeal carcinoma (NPC) in Prince of Wales Hospital (PWH), a tertiary hospital in Hong Kong. METHODS: A retrospective review on patients who underwent endoscopic nasopharyngectomy in PWH between 2015 to 2025. Patient characteristics, disease status, operative complications, resection margins, need for adjuvant treatment, recurrence and survival outcomes were analysed. RESULTS: A total of 42 subjects, including 39 recurrent NPC and 3 persistent NPC, were recruited in this study. For disease status, 33 had T1 disease, 5 had T2 disease, and 4 had T3 disease. Only 1 patient had post-operative haemorrhage requiring tracheostomy with no other major complication noted. Negative margin was achieved in 25 patients, whilst 5 patients had close margin (<1mm) and 12 patients had positive margin in final pathology. The 5-year overall survival rate is 77% and 5-year disease-free survival rate is 60%. Prognostic factor analysis showed that patients with negative surgical margin had better disease-free survival. Postoperative adjuvant radiotherapy for positive or close margin did not provide survival benefits in this cohort. CONCLUSION: Endoscopic nasopharyngectomy for recurrent or persistent NPC in our centre is of low complication rate, with comparable survival outcomes to other centres in the literature. Margin status is a significant prognostic factor for disease-free survival.