Endoscopic endonasal resection of esthesioneuroblastoma: A single center experience of 24 patients

Clin Neurol Neurosurg. 2015 Nov:138:94-8. doi: 10.1016/j.clineuro.2015.08.006. Epub 2015 Aug 13.

Abstract

Objective: Esthesioneuroblastoma (ENB) is an uncommon malignant tumor. During the past decade, endoscopic approaches have been gradually applied in treating skull base tumors. However, the experience in using this approach to treat ENB is still limited. Kadish staging and Dulguerov staging are common methods used for ENB staging, but it remains unclear as to which method is better. In this study, we reviewed our experiences with endoscopic surgeries for ENB and analyzed the prognostic roles of the two staging methods.

Methods: A total of 24 patients with ENB treated with only endoscopic endonasal surgery between January 2001 and March 2012 were included. Overall survival (OS) and disease-free survival (DFS) were analyzed using the Kaplan-Meier method and early and advanced stages were compared using the log-rank test. The prognostic roles of the two staging methods were also analyzed.

Results: Amongst the 24 patients, 19 patients presented with newly diagnosed ENB, and 5 patients presented with recurrent disease. The three-year OS and DFS rates were 82% and 70.8%, respectively. Four patients (16.6%) died from recurrence of the tumor. Dulguerov staging predicted OS with significant differences (P=0.042), whereas Kadish staging predicted DFS with significant differences (P=0.020) between the early and advanced stages.

Conclusions: The present study showed experiences that purely endoscopic endonasal surgery for ENB showed successful survival results with remarkably decreased complications. Dulguerov staging and Kadish staging play different prognostic roles in patients treated with purely endoscopic endonasal resection based on various end points.

Keywords: Endoscopic endonasal resection; Esthesioneuroblastoma; Prognostic.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Combined Modality Therapy
  • Disease-Free Survival
  • Endoscopy / methods*
  • Esthesioneuroblastoma, Olfactory / mortality
  • Esthesioneuroblastoma, Olfactory / radiotherapy
  • Esthesioneuroblastoma, Olfactory / surgery*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Nasal Cavity* / pathology
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Staging / methods
  • Nose Neoplasms / mortality
  • Nose Neoplasms / radiotherapy
  • Nose Neoplasms / surgery*
  • Retrospective Studies
  • Skull Base Neoplasms / surgery
  • Young Adult