本系统综述评估了经鼻内窥镜鼻咽切除术作为晚期复发性鼻咽癌 (rNPC) 挽救治疗的疗效和发病率。按照 PRISMA 指南，我们在 Medline、Scopus 和 PubMed 中进行了系统检索，识别了有关经鼻内窥镜鼻咽切除术的研究对于rNPC。纳入标准包括经组织学证实的 rT3 和 rT4 鼻咽癌患者，之前接受过放疗或放化疗。提取并分析了总生存期 (OS)、无病生存期 (DFS) 和并发症的数据。 9 项研究，总共 429 名患者，符合纳入标准。五项研究报告的 2 年总生存 (OS) 率范围为 34.6% 至 88.7%。三项研究报告 3 年 OS 率在 50% 至 63.5% 之间。三项研究的长期 5 年生存率差异很大，从 0% 到 100%。一项研究详细说明了 1 年无病生存率 (DFS) 和 OS 分别为 93% 和 98%。汇总分析包括 429 名患者，中位随访时间为 26.1 个月。并发症主要是轻微且短暂的。主要并发症包括坏死、出血、颅神经麻痹和死亡。先进的手术技术和预处理措施，如颈内动脉栓塞术，可改善切除效果并降低并发症发生率。经鼻内镜鼻咽切除术成为晚期 rNPC 的可行挽救选择，可提供良好的生存结果和可控的并发症。未来的研究应侧重于改进手术技术和改善患者选择标准，以进一步提高治疗效果。版权所有 © 2024 Elsevier Ltd. 保留所有权利。

This systematic review evaluates the efficacy and morbidity of transnasal endoscopic nasopharyngectomy as a salvage treatment for advanced-stage recurrent nasopharyngeal carcinoma (rNPC).Following PRISMA guidelines, we conducted a systematic search in Medline, Scopus, and PubMed, identifying studies on transnasal endoscopic nasopharyngectomy for rNPC. Inclusion criteria encompassed histologically confirmed rT3 and rT4 NPC patients previously treated with radiotherapy or chemoradiotherapy. Data on overall survival (OS), disease-free survival (DFS), and complications were extracted and analyzed.Nine studies, including a total of 429 patients, met the inclusion criteria. Five studies reported 2-year overall survival (OS) rates ranging from 34.6 % to 88.7 %. Three studies reported 3-year OS rates between 50 % and 63.5 %. Long-term 5-year survival varied widely from 0 % to 100 % across three studies. One study detailed 1-year disease-free survival (DFS) and OS at 93 % and 98 %, respectively. The pooled analysis included 429 patients with a median follow-up of 26.1 months. Complications were predominantly minor and transient. Major complications included necrosis, hemorrhage, cranial nerve palsy, and death. Advanced surgical techniques and pre-treatment measures, such as internal carotid artery embolization, improved resection outcomes and reduced complication rates.Transnasal endoscopic nasopharyngectomy emerges as a viable salvage option for advanced rNPC, offering favorable survival outcomes and manageable complication profiles. Future research should focus on refining surgical techniques and improving patient selection criteria to further enhance treatment efficacy.Copyright © 2024 Elsevier Ltd. All rights reserved.