Recommendations for surgical management of recurrent nasopharyngeal carcinoma during COVID-19 pandemic.

Nasopharyngeal carcinoma is endemic in southern parts of China including Hong Kong. Primary treatment entails radiotherapy ± chemotherapy depending on disease stage at presentation. Surgery is offered as a means of salvage for persistent and recurrent disease.

Surgical salvage of recurrent T3 nasopharyngeal carcinoma: Prognostic significance of clivus, maxillary, temporal and sphenoid bone invasion.

Background: To study the efficacy of surgery for recurrent T3 nasopharyngeal carcinoma (NPC) and to determine the prognostic significance of various skull base bone invasion.

Method: Retrospective view of the surgical outcome for recurrent T3 NPC. Kaplan Meier and log rank tests were used to determine the 5-year overall and disease specific survival.

Real time indocyanin green near infrared lymphangiography for the reduction of drainage volume after neck dissection.

Background: To investigate the role of indocyanine green (ICG) lymphangiography in the reduction of drainage after neck dissection.

Methods: Patients with oral cavity squamous cell carcinoma were randomized into Group A (study group) and Group B (control). In the study group, upon the completion of neck dissection, a total of 2.

Three-dimensional endoscopy for endoscopic salvage nasopharyngectomy: Preliminary report of experience.

Background: Prospective, observational study to assess the efficacy of salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma (NPC) via the endoscopic endonasal approach using a three-dimensional (3D) high-definition endoscopic system.

Methods: Between 2016 and 2017, 30 patients with recurrent NPC were recruited. Patient demographics, tumor characteristics, and perioperative data were recorded.

Stage II recurrent nasopharyngeal carcinoma: Prognostic significance of retropharyngeal nodal metastasis, parapharyngeal invasion, and carotid encasement.

Background: The purpose of this study was to assess the predictability of the American Joint Committee on Cancer (AJCC) staging system on patients with stage II recurrent nasopharyngeal carcinoma (NPC).

Method: We conducted a retrospective review of the surgical outcome for patients with recurrent NPC and retropharyngeal lymph node (RLN) metastasis (group I), recurrent NPC and parapharyngeal space (PPS) invasion (group II), and recurrent NPC and internal carotid artery (ICA) encasement (group III).

Results: Between 1990 and 2013, 145 patients received an operation for stage II recurrent NPC (group I, n = 62; group II, n = 65; and group III, n = 18).

Transoral robotic total laryngopharyngectomy and free jejunal flap reconstruction for hypopharyngeal cancer.

Background: To report on the feasibility of total laryngopharyngectomy and free jejunal flap transfer for patient with hypopharyngeal cancer via the transoral robotic surgery (TORS) approach.

Material And Methods: A patient with hypopharyngeal cancer involving the post-cricoid region is used for demonstration of the TORS total laryngopharyngectomy and free jejunal flap reconstruction.

Results: The procedure starts with a cruciate incision for terminal tracheostomy.

The clinical association of programmed cell death protein 4 (PDCD4) with solid tumors and its prognostic significance: a meta-analysis.

Background: Programmed cell death protein 4 (PDCD4) is a novel tumor suppressor protein involved in programmed cell death. Its association with cancer progression has been observed in multiple tumor models, but evidence supporting its association with solid tumors in humans remains controversial. This study aimed to determine the clinical significance and prognostic value of PDCD4 in solid tumors.

MicroRNA 744-3p promotes MMP-9-mediated metastasis by simultaneously suppressing PDCD4 and PTEN in laryngeal squamous cell carcinoma.

MicroRNA controls cancer invasion by governing the expression of gene regulating migration and invasion. Here, we reported a novel regulatory pathway controlled by miR-744-3p, which enhanced expression of matrix metallopeptidase 9 (MMP-9) in laryngeal squamous cell carcinoma (LSCC). We profiled the differential micoRNA expression pattern in LSCC cell lines and normal epithelial cultures derived from the head and neck mucosa using microRNA microarray.

Extracranial/intracranial vascular bypass and craniofacial resection: New hope for patients with locally advanced recurrent nasopharyngeal carcinoma.

Background: The purpose of this study was to investigate the oncologic outcome and quality of life after surgical treatment of locally advanced (rT3-rT4) recurrent nasopharyngeal carcinoma (NPC) using the staged extracranial/intracranial vascular bypass and combined craniofacial approach.

Methods: We conducted a prospective study.

Results: Between 1998 and 2013, 28 patients with rT3 to rT4 tumors were treated with the proposed surgical protocol.

Shoulder Dysfunction after Selective Neck Dissection in Recurrent Nasopharyngeal Carcinoma.

Objective: To investigate the incidence of occult nodal metastasis and severity of shoulder dysfunction after selective neck dissection (SND) for recurrent nasopharyngeal carcinoma (NPC) with N0 status.

Study Design: Prospective, single-group, pre/post test design.

Setting: Academic medical center.

The role of Epstein-Barr virus-encoded microRNA BART7 status of resection margins in the prediction of local recurrence after salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma.

Background: Local recurrence is the major cause of treatment failure in patients who undergo surgical salvage of recurrent nasopharyngeal carcinoma (NPC) after radiotherapy. The authors investigated the role of Epstein-Barr virus (EBV)-encoded Bam HI-A rightward transcript 7 microRNA (BART7) status in resection margins in the identification of a subgroup of patients who may benefit from adjuvant reradiation after surgery.

Methods: One hundred two consecutive patients who had histologically clear resection margins after undergoing nasopharyngectomy for recurrent NPC were studied.

Indocyanine green fluorescence mapping of sentinel lymph node in patients with recurrent nasopharyngeal carcinoma after previous radiotherapy.

Background: The purpose of this study was to present the feasibility of indocyanine green (ICG) mapping of sentinel lymph node in recurrent nasopharyngeal carcinoma (NPC). M1ETHODS: Peritumoral injection of 5-mg ICG solution and real-time mapping of the sentinel lymph nodes in the neck was performed during surgery. The sentinel lymph node identified was excised and sent separately for laboratory analysis.

Impact of resection margin status on outcome after salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma.

Background: The purpose of this study was to present the postoperative local tumor control and survival with regard to the different resection margin statuses during salvage nasopharyngectomy.

Methods: We conducted a whole-organ study of nasopharyngectomy specimens.

Results: Between 2005 and 2010, 126 patients underwent maxillary swing nasopharyngectomy.

Morbidities after maxillary swing nasopharyngectomy for recurrent nasopharyngeal carcinoma.

Background: The purpose of this study was to investigate the complications after maxillary swing nasopharyngectomy.

Methods: Salvage nasopharyngectomy was performed for 338 patients during 1990 to 2012. Patient and tumor characteristics, perioperative and intraoperative information, and long-term morbidities were analyzed.

Trans-oral brush biopsies and quantitative PCR for EBV DNA detection and screening of nasopharyngeal carcinoma.

Objectives: To evaluate a newly developed noninvasive ambulatory, quantitative polymerase chain reaction (Q-PCR) Epstein-Barr virus (EBV) DNA detection and screening system (NP Screen™) for nasopharyngeal carcinoma (NPC).

Study Design: Correlation of the nasopharyngeal epithelial EBV-DNA levels and clinical findings by nasopharyngoscopy and final pathologic diagnosis of NPC with biopsy.

Setting: Multicenter ENT/Oncology clinics in Hong Kong (Radiation Oncology Clinic at the Queen Elizabeth Hospital and Radiation Oncology Clinic and Head and Neck Clinic, Queen Mary Hospital, University of Hong Kong) and in Toronto, Canada (the Otolaryngology-Head and Neck Clinic at the Rouge Valley Health System and 2 large ENT practices in Toronto).

Stenting of the eustachian tube to prevent otitis media with effusion after maxillary swing approach nasopharyngectomy.

Objectives/hypothesis: Our previous report recommended that the management of ipsilateral otitis media with effusion (OME) after maxillary swing nasopharyngectomy was observation. The idea of introducing a stent into the eustachian tube (ET) at the nasopharyngeal side after nasopharyngectomy may prevent postoperative OME. The purpose of this study was to examine the feasibility of intraoperative ET stenting and the efficacy of preventing ipsilateral OME formation.

Multivariate analysis of prognostic factors for salvage nasopharyngectomy via the maxillary swing approach.

Background: The purpose of this study was to investigate the prognostic factors for salvage nasopharyngectomy.

Methods: A retrospective review was conducted on maxillary swing nasopharyngectomy performed between 1998 and 2010. Univariate and multivariate analyses identified prognostic factors affecting actuarial local tumor control and overall survival.

Radiation-induced squamous cell carcinoma of the nasopharynx after radiotherapy for nasopharyngeal carcinoma.

Background: The purpose of this study was to investigate the treatment outcome of radiation-induced squamous cell carcinoma (SCC) of the nasopharynx after radiotherapy (RT) for nasopharyngeal carcinoma (NPC).

Methods: We conducted a retrospective review of patients who underwent radiation therapy for NPC, which resulted in radiation-induced SCC of the nasopharynx.

Results: Between 1998 and 2011, 24 patients had radiation-induced SCC of the nasopharynx.

Surgical salvage for recurrent retropharyngeal lymph node metastasis in nasopharyngeal carcinoma.

Background: The purpose of this study was to analyze the surgical management of recurrent retropharyngeal lymph node metastasis after radiotherapy for nasopharyngeal carcinoma (NPC).

Methods: We conducted a prospective analysis of preoperative imaging, surgical approach, and oncological results.

Results: Between 1990 and 2011, 82 patients were included.

Mucosal melanoma of the head and neck: 32-year experience in a tertiary referral hospital.

Introduction: Primary mucosal melanomas of the head and neck (HNMM), albeit being rare, are rapidly lethal. Here we report the experience of patients with HNMM treated in our institution over a 32-year period.

Objectives/hypothesis: We aim to review our experience in managing HNMM patients over a 32-year period.

Early prediction of anastomotic leakage after free jejunal flap reconstruction of circumferential pharyngeal defects.

Background: Anastomotic leakage from the free jejunal flap, if diagnosed late, can result in catastrophes. Our study aims to look for clinical parameters that allow early identification of leakage so that appropriate interventions can be taken.

Method: Between 1980 and 2011, consecutive patients with free jejunal flap reconstruction of circumferential pharyngeal defects were included.

Postradiation sarcoma after radiotherapy for nasopharyngeal carcinoma.

Objectives/hypothesis: Postradiation sarcoma (PRS) is a notorious complication after radiotherapy (RT). The prognosis is poor, and the role of surgery is not well defined. The aim of our study was to review our experience in the management of PRS after RT for nasopharyngeal carcinoma (NPC).

The role of myringotomy and ventilation tube insertion in maxillary swing approach nasopharyngectomy: review of our 10-year experience.

Objectives/hypothesis: The use of myringotomy with ventilation tube insertion after maxillary swing nasopharyngectomy was originally described to prevent the occurrence of otitis media with effusion. The outcome of this otologic procedure has never been reviewed and discussed. The purpose of this study is to examine the role of myringotomy with ventilation tube insertion in this group of patients.

Efficacy of fine-needle aspiration in diagnosing cervical nodal metastasis from nasopharyngeal carcinoma after radiotherapy.

Objectives/hypothesis: Our purpose was to study the effect of previous radiotherapy (RT) on the efficacy of fine-needle aspiration (FNA) in diagnosing cervical nodal metastasis in nasopharyngeal carcinoma (NPC).

Study Design: Case-control study.

Methods: The diagnostic efficacy of FNA in a group of patients with residual or recurrent cervical lymphadenopathy after previous RT for NPC was compared with a cohort of patients with primary NPC before RT during the same period.

Overexpression of Epstein-Barr virus-encoded microRNA-BART7 in undifferentiated nasopharyngeal carcinoma.

Aim: To validate Epstein-Barr virus BamHI-A rightward transcript 7 microRNA (ebv-miR-BART7) expression in plasma from patients with nasopharyngeal carcinoma (NPC) and explore the oncogenic role of ebv-miR-BART7 in NPC cells.

Patients And Methods: Plasma ebv-miR-BART7 levels were measured using real-time quantitative RT-PCR. Effects on cell proliferation, invasion, migration, and resistance to cisplatin were studied on NPC cells using real-time cell analyzer.