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Survival outcomes for stage‐matched endoscopic and open resection of olfactory neuroblastoma
Author(s) -
Harvey Richard J.,
Nalavenkata Sunny,
Sacks Raymond,
Adappa Nithin D.,
Palmer James N.,
Purkey Michael T.,
Schlosser Rodney J.,
Snyderman Carl,
Wang Eric W.,
Woodworth Bradford A.,
Smee Robert,
Havas Tom,
Gallagher Richard
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24912
Subject(s) - stage (stratigraphy) , medicine , esthesioneuroblastoma , surgery , multimodal therapy , nasal cavity , paleontology , biology
Background Advanced‐stage olfactory neuroblastoma requires multimodal therapy for optimal outcomes. Debate exists over endoscopic endonasal surgery in this situation. Stage‐matched open and endoscopic surgical therapy were compared. Methods Patients from 6 cancer institutions were assessed. Stratification included dural involvement, Kadish stage, nodal disease, Hyams' grade, approach, and margin status. At follow‐up, local control, nodal status, and evidence of distant metastases were recorded with any subsequent therapy. Statistical analyses to identify risk factors for developing recurrence and survival differences were performed. Results One hundred nine patients were assessed (age 49.2 ± 13.0 years; 46% women) representing Kadish A stage (10%), Kadish B stage (25%), and Kadish C stage (65%). The majority of the patients (61.5%) underwent endoscopic resection, 53.5% within Kadish C stage. Within‐stage survival analysis favored endoscopic subgroup for Kadish C stage (log‐rank P = .017) nonsignificant for Kadish B stage (log‐rank P = .39). Conclusion Stage‐matched survival was better for the endoscopically treated group compared to the open surgery group, with high negative margin resections obtained.