화학방사선요법 후 지속 혹은 재발한 비인두암 경부 전이의 평가와 경부절제술의 수술 결과

Background and Objectives: Nasopharyngeal carcinoma (NPC) patients may have persistent or recurrent neck masses without neither primary site recurrence nor distant metastasis after chemoradiotherapy. In this study, we reviewed our experiences in patients with neck masses underwent neck dissection. Materials and Methods: Between 1994 and 2005, 16 NPC patients with recurrent or persistent neck masses after chemoradiotherapy were reviewed retrospectively. Clinical and pathological parameters were investigated. Results: Persistent or recurrent neck masses were most frequently found in level II. Alleged neck masses were confirmed as metastatic carcinoma in 81.3%. Extranodal or adjacent soft tissue involvement was found in 25.0%. Narrower range of cervical metastases were found in 28.6%, wider range of cervical metastases were found in 42.8%, equal range of cervical metastases were found in 28.6% comparing with preoperative CT scan. Local control rate, disease specific 5 year survival rate and overall 5 year survival rate was 81.3%, 67.5% and 55.0% respectively. Distant metastasis was found in 25% during follow up. Conclusions: Neck dissection could be useful treatment alternative in managing NPC patients with persistent or recurrent neck masses after chemora- diotherapy. Neck dissection covering wider range of neck level would be better to perform because clinically unexpected wide spread of metastases were frequently found. (J Clinical Otolaryngol 2010;21:226–232)