Richard J Harvey1,2,3, Sunny Nalavenkata1, Raymond Sacks1,2,4, Nithin D Adappa5, James N Palmer5, Michael T Purkey5, Rodney J Schlosser6, Carl Snyderman7, Eric W Wang7, Bradford A Woodworth8, Robert Smee9, Tom Havas10, Richard Gallagher3. 1. Applied Medical Research Centre, University of New South Wales, Kensington, Australia. 2. Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia. 3. Department of Otolaryngology - Head and Neck, Skull Base Surgery, St Vincent's Hospital, Fitzroy, Victoria, Australia. 4. Department of Otolaryngology, Concord General Hospital and Sydney University, Concord, New South Wales, Australia. 5. Department of Otorhinolaryngology/ Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania. 6. Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina. 7. Department of Otolaryngology/ Head & Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 8. Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama. 9. Department of Radiation Oncology, The Prince of Wales Cancer Centre, Prince of Wales, Australia. 10. Department of Otolaryngology, Head and Neck Surgery, The Prince of Wales Cancer Centre and Hospital, Prince of Wales, Australia.
Abstract
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.
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.
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Authors: Fernando López; Jatin P Shah; Jonathan J Beitler; Carl H Snyderman; Valerie Lund; Cesare Piazza; Antti A Mäkitie; Orlando Guntinas-Lichius; Juan P Rodrigo; Luiz P Kowalski; Miquel Quer; Ashok Shaha; Akihiro Homma; Alvaro Sanabria; Renata Ferrarotto; Anne W M Lee; Victor H F Lee; Alessandra Rinaldo; Alfio Ferlito Journal: Adv Ther Date: 2022-03-30 Impact factor: 4.070
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