Multicenter assessment of exclusive endoscopic endonasal approach for the treatment of 53 olfactory neuroblastomas

Head Neck. 2018 May;40(5):1000-1007. doi: 10.1002/hed.25064. Epub 2018 Jan 22.

Abstract

Background: Given the particularities of olfactory neuroblastoma (ONB) and the lack of studies on the subject, a multicenter collaborative study was conducted to assess treatment strategy.

Methods: Fifty-three patients with ONB were included from the French Rare Head and Neck Cancer Expert Network (REFCOR) database: 16T1, 8T2, 19T3, and 10T4. All cases were treated endoscopically with skull base removal and repair in 26 cases (49%) and without external craniotomy.

Results: The overall survival (OS) and disease-free survival (DFS) rates at 5 years were 87% and 71%, respectively, with mean follow-up of 45.4 ± 26.5 months. The complication rate was 18.8% with 4 cases of meningitis. Pathological analysis showed positive margins in 26.8%, notably on the dura-mater and periorbita, without impairment of OS or DFS. Forty-eight patients received adjuvant radiotherapy on T ± N. Ten patients had a recurrence (18.9%). Six patients died of their disease. Prophylactic neck irradiation seemed to reduce the recurrence rate.

Conclusion: Exclusively endoscopic treatment proved efficient and reliable in a large controlled series.

Keywords: endoscopic surgery; neuroblastoma; olfactory cleft; sinus cancer.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Disease-Free Survival
  • Esthesioneuroblastoma, Olfactory / mortality
  • Esthesioneuroblastoma, Olfactory / pathology
  • Esthesioneuroblastoma, Olfactory / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nasal Cavity*
  • Natural Orifice Endoscopic Surgery*
  • Nose Neoplasms / mortality
  • Nose Neoplasms / pathology
  • Nose Neoplasms / surgery*
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome