{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:49:31Z","timestamp":1782452971030,"version":"3.54.5"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis for the use of primary endoscopic nasopharyngectomy (pENPG) alone in the treatment of primary nasopharyngeal carcinoma (pNPC). To evaluate its benefits and limitations compared to current standard therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search was conducted in January 2025 using PubMed, Embase, MEDLINE, and Cochrane databases. Studies were selected based on strict inclusion\/exclusion criteria. Data was extracted on selection criteria for surgery, operation details, post-operative complications and treatment outcomes (survival outcomes and quality of life). Data was analysed using qualitative and quantitative methods and meta-analysis was performed as appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four studies involving 164 patients who underwent pENPG were identified. All studies were retrospective in nature. Two studies analysed pENPG alone, whereas the other two studies compared pENPG to intensity-modulated radiotherapy (IMRT) or open surgery. 58% of patients who underwent pENPG had localised stage I NPC (T1N0M0). Three and five-year overall survival (OS) for pENPG-treated stage I NPC was 100% in two studies. Meta-analysis for all tumour stages yielded a pooled 5-year OS of 90.6% for pENPG (\u00b1 chemoradiotherapy). One study compared pENPG vs. IMRT for stage I disease, with 5-year OS at 100% and 99.1% respectively. Radiotherapy-associated toxicities were significantly reduced with pENPG only. The severity of surgical complications correlated with the extent of resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>pENPG utilisation is rare in current practice. It may be a feasible alternative to IMRT for early stage disease to minimise radiotherapy toxicities but prospective studies are necessary to evaluate this further.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1779795","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:45:12Z","timestamp":1782452712000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary endoscopic nasopharyngectomy for nasopharyngeal carcinoma: systematic review &amp; meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Siyuan","family":"Ding","sequence":"first","affiliation":[{"name":"Department of ENT, Cambridge University Hospitals NHS Foundation Trust","place":["Cambridgeshire, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, 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