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J Neurol Surg B Skull Base 2012; 73(03): 208-220
DOI: 10.1055/s-0032-1311754
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Craniofacial Surgery for Esthesioneuroblastoma: Report of an International Collaborative Study

Snehal G. Patel
1   Department of Surgery, Memorial Sloan Kettering Cancer Center, New York
,
Bhuvanesh Singh
1   Department of Surgery, Memorial Sloan Kettering Cancer Center, New York
,
Hilda E. Stambuk
2   Department of Radiology, Memorial Sloan Kettering Cancer, New York
,
Diane Carlson
3   Laboratory Medicine/Pathology, Cleveland Clinic, Weston, Florida
,
Patrick G. Bridger
4   Prince of Wales Hospital, Sydney, New South Wales, Australia
,
Giulio Cantu
5   Instituto Nazionale, Milan, Italy
,
Anthony D. Cheesman
6   The Royal National Throat, Nose, and Ear Hospital, London, United Kingdom
,
Paul Donald
7   UC Davis, Davis, California
,
Dan Fliss
8   Department of Otolaryngology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
,
Patrick Gullane
9   Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Canada
,
Shin-etsu Kamata
10   Cancer Institute Hospital, Tokyo, Japan
,
Ivo Janecka
11   Massachusetts Eye and Ear Hospital, Boston, Massachusetts
,
Luiz P. Kowalski
12   Hospital do Cancer AC Camargo, Sao Paulo, Brazil
,
Dennis H. Kraus
1   Department of Surgery, Memorial Sloan Kettering Cancer Center, New York
,
Paul A. Levine
13   University of Virginia Health System, Charlottesville, Virginia
,
Luiz R. Medina
14   Hospital das Clinicas, Sao Paulo, Brazil
,
Sultan Pradhan
15   Tata Memorial Hospital, Mumbai, India
,
Victor Schramm
16   Center for Head and Neck Surgery, Denver, Colorado
,
Carl Snyderman
17   University of Pittsburgh, Pittsburgh, Pennsylvania
,
William I. Wei
18   University of Hong Kong, Hong Kong
,
Jatin P. Shah
1   Department of Surgery, Memorial Sloan Kettering Cancer Center, New York
› Author Affiliations
Further Information

Publication History

28 June 2011

12 July 2011

Publication Date:
07 May 2012 (online)

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Abstract

Introduction Impact of treatment and prognostic indicators of outcome are relatively ill-defined in esthesioneuroblastomas (ENB) because of the rarity of these tumors. This study was undertaken to assess the impact of craniofacial resection (CFR) on outcome of ENB.

Patients and Methods Data on 151 patients who underwent CFR for ENB were collected from 17 institutions that participated in an international collaborative study. Patient, tumor, treatment, and outcome data were collected by questionnaires and variables were analyzed for prognostic impact on overall, disease-specific and recurrence-free survival. The majority of tumors were staged Kadish stage C (116 or 77%). Overall, 90 patients (60%) had received treatment before CFR, radiation therapy in 51 (34%), and chemotherapy in 23 (15%). The margins of surgical resection were reported positive in 23 (15%) patients. Adjuvant postoperative radiation therapy was used in 51 (34%) and chemotherapy in 9 (6%) patients.

Results Treatment-related complications were reported in 49 (32%) patients. With a median follow-up of 56 months, the 5-year overall, disease-specific, and recurrence-free survival rates were 78, 83, and 64%, respectively. Intracranial extension of the disease and positive surgical margins were independent predictors of worse overall, disease-specific, and recurrence-free survival on multivariate analysis.

Conclusion This collaborative study of patients treated at various institutions across the world demonstrates the efficacy of CFR for ENB. Intracranial extension of disease and complete surgical excision were independent prognostic predictors of outcome.

Keywords

nose neoplasms/mortality/pathology/surgery/*therapy - esthesioneuroblastoma - olfactory/*therapy - combined modality therapy - radiotherapy - adjuvant - survival analysis
 

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