Thijs T G Jansen1, Johannes H A M Kaanders2, Guus N Beute3, Henri J L M Timmers4, Henri A M Marres1, Henricus P M Kunst1,5. 1. Department of otolaryngology and Head & Neck surgery, Radboudumc, Nijmegen, The Netherlands. 2. Department of Radiation Oncology, Radboudumc, Nijmegen, The Netherlands. 3. Department of Neurosurgery, St. Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands. 4. Department of Endocrinology, Radboudumc, Nijmegen, The Netherlands. 5. Department of otology and Head & Neck Surgery, MUMC+Maastricht, the Netherlands.
Abstract
OBJECTIVES: To identify the risks associated with surgery, radiotherapy or a combined treatment approach for Fisch class C and D jugulotympanic paraganglioma, in order to develop an individualised approach for each patient depending on Fisch class, age, mutation presence, tumour size growth rate and presenting symptoms. DESIGN: A retrospective multicenter cohort study with all patient records of patients with a head and neck paraganglioma in the Radboudumc, Nijmegen and the St. Elisabeth Hospital, Tilburg, the Netherlands. MAIN OUTCOME MEASURES: Local control, cranial nerve damage, complications, function recovery. RESULTS: We found highest local control rates after tumour debulking with postoperative radiotherapy in case of residual tumour growth, referred to as the combined treatment group, (100%; n = 19), which was significantly higher than the surgical group (82%; n = 17; P = 0.00), but did not differ from the radiotherapy group (90%; n = 29). There were significantly less complications in the radiotherapy group, when compared to surgery (63 vs 27%; P = 0.002) and the combined group (44 vs 27%; P = 0.016). Furthermore,: using a logistic regression model, we found that pretreatment tumour growth was a negative predictor for post-treatment cranial nerve function recovery (OR = 50.178, P = 0.001), reducing the chance of symptom recovery (67.3% vs 35.7%) post-treatment. CONCLUSIONS: Radiotherapy should be the treatment of choice for the elderly. For younger patients, tumour debulking should be considered, with potential radiotherapy in case of residual tumour growth.
OBJECTIVES: To identify the risks associated with surgery, radiotherapy or a combined treatment approach for Fisch class C and D jugulotympanic paraganglioma, in order to develop an individualised approach for each patient depending on Fisch class, age, mutation presence, tumour size growth rate and presenting symptoms. DESIGN: A retrospective multicenter cohort study with all patient records of patients with a head and neck paraganglioma in the Radboudumc, Nijmegen and the St. Elisabeth Hospital, Tilburg, the Netherlands. MAIN OUTCOME MEASURES: Local control, cranial nerve damage, complications, function recovery. RESULTS: We found highest local control rates after tumour debulking with postoperative radiotherapy in case of residual tumour growth, referred to as the combined treatment group, (100%; n = 19), which was significantly higher than the surgical group (82%; n = 17; P = 0.00), but did not differ from the radiotherapy group (90%; n = 29). There were significantly less complications in the radiotherapy group, when compared to surgery (63 vs 27%; P = 0.002) and the combined group (44 vs 27%; P = 0.016). Furthermore,: using a logistic regression model, we found that pretreatment tumour growth was a negative predictor for post-treatment cranial nerve function recovery (OR = 50.178, P = 0.001), reducing the chance of symptom recovery (67.3% vs 35.7%) post-treatment. CONCLUSIONS: Radiotherapy should be the treatment of choice for the elderly. For younger patients, tumour debulking should be considered, with potential radiotherapy in case of residual tumour growth.
Authors: Randall J Harley; Jason H Lee; Benjamin T Ostrander; Andrey Finegersh; Tammy B Pham; Kareem O Tawfik; Yin Ren; Farhoud Faraji; Rick A Friedman Journal: OTO Open Date: 2022-03-31
Authors: Benedicto Oscar Colli; Carlos Gilberto Carlotti Junior; Ricardo Santos de Oliveira; Guilherme Gozzoli Podolski Gondim; Daniel Giansanti Abud; Eduardo Tanaka Massuda; Francisco Veríssimo de Melo Filho; Koji Tanaka Journal: Surg Neurol Int Date: 2021-09-30