Multicenter assessment of exclusive endoscopic endonasal approach for the treatment of 53 olfactory neuroblastomas (original) (raw)
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PloS one, 2016
To summarize the characteristics and long-term outcomes of olfactory neuroblastoma through the analysis of 13 cases in single institution, with the assessment of treatment modality, prognostic factors. A retrospective study of thirteen cases diagnosed as olfactory neuroblastoma and underwent combined treatments during the period 2000-2010. Statistical analysis was performed to search for prognostic factors and compared different treatment modalities. 13 patients were enrolled in this study, including 8 male and 5 female, ranging from 15 to 69 (median 43) years old. One patient at stage A was only treated with endoscopic endonasal surgery (EES). Seven patients were treated with preoperative radiotherapy and EES, two with EES and postoperative radiotherapy, and the other three with combined radiotherapy and chemotherapy. The range of follow-up time varied from 23 to 116 months (median 65 months). The 5-year overall survival rate was 46.2% (6/13). To date, these thirteen patients have ...
Journal of Cancer Therapy, 2012
This paper presents a case of an olfactory neuroblastoma, treated with minimally invasive endoscopic resection, followed by adjuvant radiotherapy and critically reviews the current literature with regard to diagnosis and management of such malignancies. Olfactory neuroblastoma is considered to be an uncommon malignancy of the nasal cavity. The tumor arises from the specialized sensory epithelial olfactory cells, normally situated at the upper part of the nasal cavity, including the superior nasal concha, the roof of the nose and the cribriform plate. The imaging modality of choice is computed tomography and magnetic resonance imaging. Combination of surgery and radiotherapy is considered to be the standard of care for primary site disease by the majority of researchers. Combined transfacial and neurosurgical conventional approaches are adopted in most cases, mainly due to the endocranial extension and the close anatomic relationship of esthesioneuroblastomas with the ethmoid roof and cribriform plate. However, recent literature supports that endoscopic resection correlates with similar oncologic control rates, compared with open surgery, when basic oncologic surgical principles are maintained.
Olfactory neuroblastoma: The 22-year experience at one comprehensive cancer center
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2005
Background.Olfactory neuroblastoma (ONB) is a rare tumor arising from the olfactory neuroepithelium. There is no universally accepted staging system, and treatment approaches lack uniformity. We present one institution's experience with this tumor and the results of therapy.Olfactory neuroblastoma (ONB) is a rare tumor arising from the olfactory neuroepithelium. There is no universally accepted staging system, and treatment approaches lack uniformity. We present one institution's experience with this tumor and the results of therapy.Methods.Thirty patients treated for ONB at The University of Texas M. D. Anderson Cancer Center between 1979 and 2002 were retrospectively reviewed. The diagnosis of ONB was histologically confirmed for each patient.Thirty patients treated for ONB at The University of Texas M. D. Anderson Cancer Center between 1979 and 2002 were retrospectively reviewed. The diagnosis of ONB was histologically confirmed for each patient.Results.The mean follow-up was 7.32 years. In 77% of cases, patients received treatment with surgery followed by postoperative radiation therapy. Sixteen percent received chemotherapy as part of their initial treatment. Overall 5-year and 10-year survival rates were 89% and 81%, respectively. Nine patients whose disease was initially stage C had a recurrence. The mean time for recurrence was 4.67 years.The mean follow-up was 7.32 years. In 77% of cases, patients received treatment with surgery followed by postoperative radiation therapy. Sixteen percent received chemotherapy as part of their initial treatment. Overall 5-year and 10-year survival rates were 89% and 81%, respectively. Nine patients whose disease was initially stage C had a recurrence. The mean time for recurrence was 4.67 years.Conclusions.The M. D. Anderson Cancer Center approach to ONB is complete surgical resection, usually involving a craniofacial approach, with postoperative radiation therapy. This approach seems to be curative in early-stage disease. Late recurrence warrants long-term follow-up. © 2005 Wiley Periodicals, Inc. Head Neck27: 138–149, 2005The M. D. Anderson Cancer Center approach to ONB is complete surgical resection, usually involving a craniofacial approach, with postoperative radiation therapy. This approach seems to be curative in early-stage disease. Late recurrence warrants long-term follow-up. © 2005 Wiley Periodicals, Inc. Head Neck27: 138–149, 2005
Journal of Neurological Surgery Part B: Skull Base, 2017
Objective We aimed to compare major complication rates in patients undergoing open versus endoscopic resection of olfactory neuroblastoma (ONB) and to determine the prognostic utility of the Kadish staging and Hyams grading systems with respect to progression-free survival (PFS) and overall survival (OS). Methods It is a retrospective review of experience in treating ONB at a single tertiary care hospital from 1987 through 2015. Major complications were defined as cerebrospinal fluid (CSF) leak, meningitis, osteomyelitis, tracheostomy, and severe neurologic injury. Results Forty-one patients were included. An open approach was used in 34 (83%), endoscopic in 6 (15%), and combined in 1 (2%) case. Rates of major complications by surgical approach were 17% after endoscopic versus 31% after open (p = 0.65). There was no significant difference in PFS or OS based on Kadish B versus C (PFS, p = 0.28; OS, p = 0.11) or Hyams grade 1 and 2 versus Hyams grade 3 and 4 (PFS, p = 0.53; OS, p = 0....
The …, 2000
Objectives: To describe a new treatment modality of olfactory neuroblastoma consisting of endoscopic nasal and paranasal sinus surgery and stereotactic radiosurgery. Study Design: Retrospective review of three patients suffering from olfactory neuroblastoma. Methods: Review of the charts, the computed tomography, and magnetic resonance imaging scans, the operation reports, radiosurgical data, and followup. Results: All three patients remained free of disease with excellent quality of life in respective follow-up periods of 71, 50, and 39 months. Conclusion: The combination of two minimally invasive therapies, endoscopic sinus surgery and stereotactic radiosurgery, provide a reliable new approach to the treatment of a series of olfactory neuroblastomas that offers excellent quality of life, less injury to the patient, fewer side-effects, and fewer long-term effects than other treatment strategies.
Treatment of olfactory neuroblastoma: a new approach
Acta Neurologica Belgica, 2014
A 24-year-old male presented with a 6-month history of progressive left nasal obstruction, hypoanosmia, and discrete enophthalmos. As well, hypertension is present for years and peeling hands of palmar side 2-3 times a year during the winter months. Computed tomography and magnetic resonance imaging of the head showed an expansive mass in the left maxillary sinus of maximum oblique diameter 47 mm, extending into the nasal cavity ). There was a partial dehiscence of the medial wall of the left maxillary sinus. Magnetic resonance angiography indicated a slightly higher caliber of maxillary artery on the left side and cervical artery angiography identified visible signs of pathological vascularization of the tumor mass, which comes from branches of the left maxillary artery and ophthalmic artery ). According to MRI examination, structure of tumor mass was nonhomogeneous, with numerous flow-voids that indicate the good vascularization. Intrusion of the mass through expanded sinus antrum was present in middle meatus. After application of contrast, intensive and easily nonhomogeneous staining was displayed.
Olfactory Neuroblastomas: An Experience of 24 Years
Objective. The aim of this study was to evaluate clinicopathological findings and the efficacy of the treatment modalities used in patients with olfactory neuroblastomas. Study Design. Retrospective record review. Setting. Istanbul University, Cerrahpasa Medical Faculty, medical oncology outpatient clinic. Subjects and Methods. There were 3 stage A tumors, 5 stage B and 11 stage C according to the Kadish staging system. There were 5 grade I/II and 12 grade III/IV according to the Hyams' histopathologic system. Involvement to orbita was detected in eight patients at the time of diagnosis. Results. The median follow-up period was 23.7 months. The 5-year survival rate for the whole group was 26%. The stage A/B groups exhibited a better survival rate than the C group with 2-year survival rates being 25 versus 71% respectively (P = .008). The grade I/II groups exhibited a better survival rate than the grade III/IV groups with 2-year survival rates being 50 versus 16% respectively (P = .001). The group who had orbital involvement exhibited a poor survival rate than the group of patients who had no involvement of the orbital. Conclusion. In our study, tumor stage, histopathologic grading, involvement of the orbita, brain and bone marow metastases were the statistically significant prognostic factors.
Olfactory neuroblastoma: Up-to-date review and our experience
Romanian Journal of Rhinology
Olfactory neuroblastoma (ONB), also known as esthesioneuroblastoma, is a rare malignant neuroectodermal tumor originating primarily from the basal layer of the olfactory epithelium in the roof of the nasal cavity. The most common symptoms are nasal obstruction, anosmia, recurrent epistaxis, rhinorrhea and excessive lacrimation. Imaging studies are helpful for assessing the extent of olfactory neuroblastoma, as well as grading the tumor. The definitive diagnosis is based on histopathological exam and immunohistochemistry profile and it might be quite challenging because the tumor can mimic other sinonasal malignancies. Because of the small number of reported cases and the lack of prospective research, the optimal treatment for olfactory neuroblastoma is still controversial. However, it is generally believed that surgical resection followed by radiotherapy gives the best outcome in terms of recurrence and survival rates. Keeping in mind the rarity of olfactory neuroblastoma and the di...
Olfactory Neuroblastoma: A 15-Year Single Institution Experience
Reports of Radiotherapy and Oncology, 2015
Background: Olfactory neuroblastoma or esthesioneuroblastoma is a rare malignant neoplasm of the olfactory neuroepithelium. Objectives: This study aimed to investigate the clinical presentation, characteristics and treatment outcome of fourteen patients with olfactory neuroblastoma. Patients and Methods: This retrospective study reviewed and analyzed 14 patients with olfactory neuroblastoma during the last 15 years at two referral tertiary academic hospitals of Shiraz University of Medical Sciences. Patients under 16 years old were excluded from the study. Kadish classification was used for staging the tumors. In addition, the tumors were histopathologically graded according to Hyams' grading classification. Results: There were 6 women (43%) and 8 men (57%) ranging from 16 to 56 years old, with a median age of 40 years at diagnosis. Nasal obstruction (93%), facial or sinus pain (57%), and nasal bleeding (43%) were the most frequent presentation. Two patients (14%) had stage A, 3 (21.5%) had stage B, 6 (43%) had stage C, and 3 (21.5%) had stage D disease. After initial treatment, five patients developed local and/or distant recurrent disease. After a median follow-up of 73 (range 14-108) months for surviving patients, 10 patients (71.5%) were alive and without disease, one (7%) was alive with disease, and 3 (21.5%) died due to the disease. The 5-year disease-free and overall survival rates were 71.4% and 75.7%, respectively. Conclusions: At our center, patients with olfactory neuroblastoma tend to present at advanced stages; therefore, combined local treatment and incorporation of chemotherapy may improve outcome.