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. 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. 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% (9572%-93%), 68%(9559%-77%),respectively.The pooled 2-year disease-free survival rates of endoscopic and open group were 68%(9553%-81%), 65%(9554%-75%),respectively. The pooled 5-year overall survival rates of endoscopic and open group were 72%(9537%-97%), 48% (9540%-56%),respectively.The pooled 5-year disease-free survival rates of endoscopic and open group were 65%(9529%-93%), 50%(9543%-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. 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.
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| http://dx.doi.org/10.3760/cma.j.issn.1673-0860.2019.09.006 | DOI Listing |
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