Archives of otolaryngology--head & neck surgery · 2006
Esthesioneuroblastoma: continued follow-up of a single institution's experience.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Loy Andrew H, Reibel James F, Read Paul W, Thomas Christopher Y, Newman Steven A, Jane John A, Levine Paul A
Аннотация
OBJECTIVES: To analyze outcomes and to provide follow-up for our increasing patient cohort with esthesioneuroblastoma.
DESIGN: Retrospective cohort analysis.
SETTING: Patients were examined from September 1, 1976, to May 30, 2004, in a tertiary care academic hospital.
PATIENTS: Fifty consecutive patients diagnosed as having esthesioneuroblastoma were treated with a standardized protocol during a 28-year period. Patients with tumors staged Kadish A or B received preoperative radiotherapy followed by craniofacial resection, while patients with Kadish stage C disease were treated with preoperative sequential chemotherapy and radiotherapy followed by a craniofacial resection. The mean follow-up is 93 months (range, 1-330 months).
RESULTS: The disease-free survival was 86.5% and 82.6% at 5 and 15 years, respectively. There were 17 patients (34%) who developed recurrent disease, most of which was locoregional (12 patients [71%]). There was a long interval to relapse (mean, 6 years), with the longest time to regional recurrence being 10 years. Distant relapses occurred sooner, with poorer outcomes. Of these 17 patients, 7 (41%) underwent successful salvage surgery, while 3 remain alive with disease.
CONCLUSIONS: Excellent outcomes for esthesioneuroblastoma are achievable. Long-term follow-up is necessary because of the extended interval for recurrent disease; unlike most sinonasal malignancies, surgical salvage is possible.
DESIGN: Retrospective cohort analysis.
SETTING: Patients were examined from September 1, 1976, to May 30, 2004, in a tertiary care academic hospital.
PATIENTS: Fifty consecutive patients diagnosed as having esthesioneuroblastoma were treated with a standardized protocol during a 28-year period. Patients with tumors staged Kadish A or B received preoperative radiotherapy followed by craniofacial resection, while patients with Kadish stage C disease were treated with preoperative sequential chemotherapy and radiotherapy followed by a craniofacial resection. The mean follow-up is 93 months (range, 1-330 months).
RESULTS: The disease-free survival was 86.5% and 82.6% at 5 and 15 years, respectively. There were 17 patients (34%) who developed recurrent disease, most of which was locoregional (12 patients [71%]). There was a long interval to relapse (mean, 6 years), with the longest time to regional recurrence being 10 years. Distant relapses occurred sooner, with poorer outcomes. Of these 17 patients, 7 (41%) underwent successful salvage surgery, while 3 remain alive with disease.
CONCLUSIONS: Excellent outcomes for esthesioneuroblastoma are achievable. Long-term follow-up is necessary because of the extended interval for recurrent disease; unlike most sinonasal malignancies, surgical salvage is possible.
Предметные рубрики MeSH
AdolescentAdultAgedAntineoplastic Combined Chemotherapy ProtocolsChildCyclophosphamideDoxorubicinEsthesioneuroblastoma, OlfactoryFemaleFollow-Up StudiesHumansMaleMiddle AgedNasal CavityNeoplasm Recurrence, LocalNeurosurgical ProceduresNose NeoplasmsRadiotherapy, AdjuvantRetrospective StudiesTreatment OutcomeVincristine