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Y-F. Ouyang - Q-L. Lin - A-C. Li - J-Y. Song - R-L. Xie

DOI: 10.4193/Rhin24.403

Background: Nasopharyngeal necrosis is a common sequela after treatment for nasopharyngeal carcinoma (NPC). This study
aims to compare the effectiveness of the main interventions, endoscopic surgery and conservative therapy, on nasopharyngeal
necrosis and identify potential beneficiaries.
Methodology: This retrospective study was conducted on patients with nasopharyngeal necrosis from September 2008 to December
2020 at the Cancer Hospital of Sun Yat-sen University. The overall survival (OS) of patients with nasopharyngeal necrosis
and their mucosal healing status were assessed. Propensity score matching (PSM) and inverse probability of treatment weighting
(IPTW) were used to balance confounding factors between the two groups.
Results: A total of 517 patients (124 females; 393 males) with nasopharyngeal necrosis were included in this analysis, among
whom 287 received conservative therapy and 230 underwent endoscopic surgical treatment. In the unmatched cohort, the
endoscopic surgery group had a higher 3-year OS rate than the conservative therapy group. Patients who underwent surgery had
higher cure rates than did those who received conservative therapy. PSM and IPTW analyses yielded similar results. Multivariate
analyses of the unmatched, PSM, and IPTW cohorts revealed that nasal endoscopic surgery was an independent protective factor
for the OS of patients with nasopharyngeal necrosis.
Conclusions: In this retrospective research, endoscopic surgery demonstrated better efficacy than conservative therapy for
nasopharyngeal carcinoma patients with nasopharyngeal necrosis, while conservative therapy may be preferred for patients with
superficial mucosal necrosis.

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