Gary L Gallia1,2,3, Anthony O Asemota1, Ari M Blitz4, Andrew P Lane2, Wayne Koch2, Douglas D Reh1,2, Masaru Ishii1,2. 1. Departments of1Neurosurgery. 2. 2Otolaryngology/Head and Neck Surgery, and. 3. 3Oncology, and. 4. 4Division of Neuroradiology, Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Abstract
OBJECTIVE: Olfactory neuroblastoma (ONB) is a rare malignant neoplasm of the sinonasal cavity. Surgery has been and remains a mainstay of treatment for patients with this tumor. Open craniofacial resections have been the treatment of choice for many decades. More recently, experience has been growing with endoscopic approaches in the management of patients with ONB. The object of this study is to report the authors' experience over the past 11 years with ONB patients treated with purely endonasal endoscopic techniques. METHODS: The authors performed a retrospective chart review of 20 consecutive patients with ONB who underwent a completely endonasal endoscopic approach for an oncological tumor resection at their institution between January 2006 and January 2017. Patient demographics, tumor stage, pathological grade, frozen section analysis, permanent margin assessment, perioperative complications, postoperative therapy, length of follow-up, and outcomes at last follow-up were collected and analyzed. RESULTS: Eighteen patients presented with newly diagnosed disease, with a modified Kadish stage of A in 2 cases, B in 3, C in 11, and D in 2. Two patients presented with recurrent tumors. An average of 25.3 specimens per patient were examined by frozen section analysis. Although analysis of intraoperative frozen section margins was negative in all but 1 case, microscopic foci of tumor were found in 7 cases (35%) on permanent histopathological analysis. Perioperative complications occurred in 7 patients (35%) including 1 patient who developed a cerebrospinal fluid leak; there were no episodes of meningitis. All but 1 patient received postoperative radiotherapy, and 5 patients received postoperative chemotherapy. With a mean follow-up of over 5 years, 19 patients were alive and 1 patient died from an unrelated cause. There were 2 cases of tumor recurrence. The 5-year overall, disease-specific, and recurrence-free survival rates were 92.9%, 100%, and 92.9%, respectively. CONCLUSIONS: The current results provide additional evidence for the continued use of endoscopic procedures in the management of this malignancy.
OBJECTIVE:Olfactory neuroblastoma (ONB) is a rare malignant neoplasm of the sinonasal cavity. Surgery has been and remains a mainstay of treatment for patients with this tumor. Open craniofacial resections have been the treatment of choice for many decades. More recently, experience has been growing with endoscopic approaches in the management of patients with ONB. The object of this study is to report the authors' experience over the past 11 years with ONB patients treated with purely endonasal endoscopic techniques. METHODS: The authors performed a retrospective chart review of 20 consecutive patients with ONB who underwent a completely endonasal endoscopic approach for an oncological tumor resection at their institution between January 2006 and January 2017. Patient demographics, tumor stage, pathological grade, frozen section analysis, permanent margin assessment, perioperative complications, postoperative therapy, length of follow-up, and outcomes at last follow-up were collected and analyzed. RESULTS: Eighteen patients presented with newly diagnosed disease, with a modified Kadish stage of A in 2 cases, B in 3, C in 11, and D in 2. Two patients presented with recurrent tumors. An average of 25.3 specimens per patient were examined by frozen section analysis. Although analysis of intraoperative frozen section margins was negative in all but 1 case, microscopic foci of tumor were found in 7 cases (35%) on permanent histopathological analysis. Perioperative complications occurred in 7 patients (35%) including 1 patient who developed a cerebrospinal fluid leak; there were no episodes of meningitis. All but 1 patient received postoperative radiotherapy, and 5 patients received postoperative chemotherapy. With a mean follow-up of over 5 years, 19 patients were alive and 1 patient died from an unrelated cause. There were 2 cases of tumor recurrence. The 5-year overall, disease-specific, and recurrence-free survival rates were 92.9%, 100%, and 92.9%, respectively. CONCLUSIONS: The current results provide additional evidence for the continued use of endoscopic procedures in the management of this malignancy.
Authors: Matt Lechner; Yoko Takahashi; Mario Turri-Zanoni; Jacklyn Liu; Nicholas Counsell; Mario Hermsen; Raman Preet Kaur; Tianna Zhao; Murugappan Ramanathan; Volker H Schartinger; Oscar Emanuel; Sam Helman; Jordan Varghese; Jozsef Dudas; Herbert Riechelmann; Susanne Sprung; Johannes Haybaeck; David Howard; Nils Wolfgang Engel; Sarah Stewart; Laura Brooks; Jessica C Pickles; Thomas S Jacques; Tim R Fenton; Luke Williams; Francis M Vaz; Paul O'Flynn; Paul Stimpson; Simon Wang; S Alam Hannan; Samit Unadkat; Jonathan Hughes; Raghav Dwivedi; Cillian T Forde; Premjit Randhawa; Simon Gane; Jonathan Joseph; Peter J Andrews; Gary Royle; Alessandro Franchi; Roberta Maragliano; Simonetta Battocchio; Helen Bewicke-Copley; Christodoulos Pipinikas; Amy Webster; Chrissie Thirlwell; Debbie Ho; Andrew Teschendorff; Tianyu Zhu; Christopher D Steele; Nischalan Pillay; Bart Vanhaesebroeck; Ahmed Mohyeldin; Juan Fernandez-Miranda; Ki Wan Park; Quynh-Thu Le; Robert B West; Rami Saade; R Peter Manes; Sacit Bulent Omay; Eugenia M Vining; Benjamin L Judson; Wendell G Yarbrough; Maddalena Sansovini; Nicolini Silvia; Ilaria Grassi; Alberto Bongiovanni; David Capper; Ulrich Schüller; Selvam Thavaraj; Ann Sandison; Pavol Surda; Claire Hopkins; Marco Ferrari; Davide Mattavelli; Vittorio Rampinelli; Fabio Facchetti; Piero Nicolai; Paolo Bossi; Oswaldo A Henriquez; Kelly Magliocca; C Arturo Solares; Sarah K Wise; Jose L Llorente; Zara M Patel; Jayakar V Nayak; Peter H Hwang; Peter D Lacy; Robbie Woods; James P O'Neill; Amrita Jay; Dawn Carnell; Martin D Forster; Masaru Ishii; Nyall R London; Diana M Bell; Gary L Gallia; Paolo Castelnuovo; Stefano Severi; Valerie J Lund; Ehab Y Hanna Journal: Eur J Cancer Date: 2021-12-31 Impact factor: 10.002
Authors: Daniel B Spielman; Andi Liebowitz; Maeher Grewal; Chetan Safi; Jonathan B Overdevest; Alfred M Iloreta; Brett E Youngerman; David A Gudis Journal: World J Otorhinolaryngol Head Neck Surg Date: 2022-03-22