To evaluate the benefits and limitations of primary endoscopic nasopharyngectomy (pENPG) alone compared to current standard therapy for primary nasopharyngeal carcinoma (pNPC).
Approach:
Literature Search: Conducted in January 2025 using PubMed, Embase, MEDLINE, and Cochrane databases with strict inclusion/exclusion criteria.
Data Extraction: Extracted data on selection criteria for surgery, operation details, post-operative complications, and treatment outcomes related to survival and quality of life.
Meta-Analysis: Performed qualitative and quantitative analysis as appropriate.
Key Findings:
Four studies involving 164 patients undergoing pENPG were identified, all retrospective.
58% of patients had localized stage I NPC (T1N0M0).
Pooled 5-year overall survival (OS) for pENPG was 90.6%.
5-year OS for pENPG vs. IMRT for stage I disease was 100% vs. 99.1%, respectively.
Radiotherapy-associated toxicities were significantly reduced with pENPG.
Interpretation:
pENPG may be a feasible alternative to IMRT for early-stage NPC to minimize radiotherapy toxicities, but further prospective studies are necessary.
Limitations:
The studies included were all retrospective in nature.
pENPG utilization is rare in current practice, which may affect the generalizability of the findings.
Conclusion:
Further prospective studies are needed to evaluate the efficacy and safety of pENPG in treating nasopharyngeal carcinoma.
