Craniofacial Surgery for Esthesioneuroblastoma: Report of an International Collaborative Study

Abstract

Introduction Impact of treatment and prognostic indicators of outcome are relatively ill-defined in esthesioneuroblastomas (ENB) because of the rarity of these tumors. This study was undertaken to assess the impact of craniofacial resection (CFR) on outcome of ENB. Patients and Methods Data on 151 patients who underwent CFR for ENB were collected from 17 institutions that participated in an international collaborative study. Patient, tumor, treatment, and outcome data were collected by questionnaires and variables were analyzed for prognostic impact on overall, disease-specific and recurrence-free survival. The majority of tumors were staged Kadish stage C (116 or 77%). Overall, 90 patients (60%) had received treatment before CFR, radiation therapy in 51 (34%), and chemotherapy in 23 (15%). The margins of surgical resection were reported positive in 23 (15%) patients. Adjuvant postoperative radiation therapy was used in 51 (34%) and chemotherapy in 9 (6%) patients.

Assessment of frozen section margin analysis during olfactory neuroblastoma surgery

“…The goal of surgical resection of sinonasal malignancies, including ONB, is a negative margin resection . An international collaborative study of 151 patients with ONB who underwent craniofacial resection demonstrated that a negative margin resection provides a significant survival advantage . Similar findings have also been shown in several other studies .…”

Importance of Tumor Grade in Esthesioneuroblastoma Survival

“…Other studies have identified the Kadish system, T staging of Dulguerov-Calcaterra, tumor grade, nodal involvement, and radiation dose to also be factors. 3,4,11 In this study, multivariable Cox regression analysis revealed advanced age, tumor grade, and modified Kadish stage to be negative independent predictors of OS, while female sex independently predicted better OS. The effect of age and sex on all-cause survival is expected in this analysis because the OS rate includes extraneous deaths from expected age-related mortality.…”

Comparison of outcomes for open versus endoscopic approaches for olfactory neuroblastoma: A systematic review and individual participant data meta‐analysis

“…En bloc resection via an open approach, such as craniofacial surgery, is the current standard of treatment. The literature reports 5‐year OS rates for open approaches ranging from 55% to 89%, and 5‐year DSS rates from 46% to 83% . However, craniofacial surgery remains an invasive procedure with significant perioperative morbidity.…”