Esthesioneuroblastoma: 25-year experience at a single institution
Presented at American Academy of Otolaryngology–Head and Neck Surgery Annual Meeting, Washington, DC, September 19, 2007.
Received 31 August 2007; received in revised form 3 December 2007; accepted 26 December 2007.
Objectives
To evaluate outcomes for patients with esthesioneuroblastoma treated at a single institution during a 25-year period.
Design
Eighteen patients with pathologic diagnosis of esthesioneuroblastoma between 1980 and 2004 were retrospectively identified.
Results
Two patients had Kadish A, seven had Kadish B, and nine had Kadish C disease. The mean follow-up was 71 months. Treatment regimens consisted of surgery alone (four patients), surgery followed by postoperative radiation (six patients), surgery followed by postoperative chemoradiotherapy (three patients), preoperative radiotherapy (two patients), preoperative chemoradiotherapy (one patient), chemoradiotherapy (one patient), and surgery plus chemotherapy (one patient). Surgical approaches (n = 17) consisted of 13 traditional craniofacial resections, one endoscopic-assisted cranionasal resection, and three minimally invasive endoscopic resections. The 10-year disease-specific survival was 80%. The overall recurrence-free survival at five and 10 years was 62% and 46%, respectively. Positive surgical margins and TNM staging predicted survival.
Conclusion
Both endoscopic and open surgical approaches have been successful in treating a small number of esthesioneuroblastoma patients with high survival and low rate of surgical complications.
aBobby R. Alford Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine, Houston, TX
bDepartment of Otolaryngology–Head and Neck Surgery, University of Texas Medical School at Houston, Houston, TX
cDepartment of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, OH
dSection of Nasal and Sinus Disorders, Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, OH
eSection of Skull Base Surgery, Center for Brain Tumors and Neuro-Oncology/Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, OH
fSinus and Nasal Institute of Florida, St. Petersburg, FL.
Corresponding author: Dr Samer Fakhri, Department of Otolaryngology–Head and Neck Surgery, University of Texas Medical School at Houston, 6410 Fannin, Suite 1200, Houston, TX 77030.
ABSTRACT