Surgical Management of Esthesioneuroblastoma at a Single Tertiary Care Center

Abstract

Objectives

To analyze management strategies and outcomes for patients with esthesioneuroblastoma (ENB) undergoing surgical resection at a single institution.

Methods

Retrospective review from 1971 to 2022 from a single, high-volume tertiary academic center of all patients with ENB.

Results

A total of 60 patients received their primary treatment for ENB at our institution. The average age at diagnosis was 52 years (range 13–91), and most were male (66.7%) with Kadish C (61.7%) stage at presentation. Most patients were treated with an open approach (68.3%) compared with a purely endoscopic approach (31.7%). Median follow-up was 96.9 months (mean 118.8 months, interquartile range 28.4–183.8 months). There was one patient with local recurrence in the endoscopic cohort (5.3%) compared with 22.0% (9 patients) among those who underwent an open resection (p = 0.21). The 5-year survival was 87.2% (95% CI, 71.9–100.0%) in the endoscopic cohort compared with 80.2% (95% CI, 68.8–93.5%) in the open group (p = 0.60). The rate of death or recurrence within 5 years of treatment was comparable between open and endoscopic (32.5% vs. 15.0%, p = 0.26). Among Kadish C patients treated in the endoscopic era (after 2006), 5-year survival was 76.2% (95% CI, 52.1–100.0%) in the endoscopic cohort and 64.8% (95% CI, 39.3–100.0%) in the open group (p = 0.70).

Conclusion

The surgical approach for ENB resection is dictated by tumor extension. Endoscopic resection offers a less invasive approach with comparable postoperative outcomes in appropriately selected patients.

Keywords

esthesioneuroblastoma - endoscopic - olfactory neuroblastoma - anterior - skull base

Publication History

Received: 05 November 2024

Accepted: 12 April 2025

Accepted Manuscript online:
15 April 2025

Article published online:
30 April 2025

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