Multicenter assessment of exclusive endoscopic endonasal approach for the treatment of 53 olfactory neuroblastomas

Gabory, L. de; Vérillaud, Benjamin; Rumeau, C.; Herman, Philippe; Jankowski, R.; Michel, J.; Kermadec, H. De; Coste, A.; Mortuaire, G.; Righini, Christian; Reyt, É.; Choussy, O.; Trévillot, V.; Crampette, L.; Serrano, É.; Tsaranazy, Anjarasoa; Bastier, Pierre-Louis; Vergez, S.

doi:10.1002/hed.25064

Cited by 23 publications

(27 citation statements)

References 30 publications

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“…After title and abstract review, 350 articles were rejected and full-texts of the remaining 66 papers were obtained for further review. After applying the aforementioned eligibility criteria, a total of 9 studies were included in the qualitative and quantitative synthesis (22)(23)(24)(25)(26)(27)(28)(29)(30) . The reasons behind the exclusions of the other studies are shown in Figure 1.…”

Section: Literature Search Resultsmentioning

confidence: 99%

Elective neck irradiation in the management of esthesioneuroblastoma: a systematic review and meta-analysis

Costantino¹,

Sebastiani²,

Russo³

et al. 2021

Rhin

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Background: There is no consensus about the optimal management of the neck in clinically node negative esthesioneuroblastoma (ENB). The aim of this study is to assess the impact of elective neck irradiation (ENI) in terms of regional disease control and survival. Methods: The study was performed according to the PRISMA guidelines searching on Scopus, PubMed/MEDLINE, and Google Scholar databases. The primary outcome was the regional recurrence rate (RRR), that was reported as odds ratio (OR) and 95% confidence interval (CI). Secondary outcomes were the overall survival (OS), and the distant-metastases free survival (DMFS), that were reported as logarithm of the hazard ratios (logHRs) and 95% confidence intervals (CIs). Results: A total of 489 clinically node negative patients were included from 9 retrospective studies. ENI significantly reduced the risk of regional recurrence compared to no treatment. No difference was measured between ENI and observation, according to both OS and DMFS. No stratified analysis could be performed based on Kadish stage and Hyams grade. Conclusions: ENI should be recommended to improve the regional disease control. No advantage was measured in terms of survival or distant metastases with a low quality of evidence. Further prospective studies should be designed to understand if ENI could be avoided in early stage and low-grade tumors.

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Section: Literature Search Resultsmentioning

confidence: 99%

Elective neck irradiation in the management of esthesioneuroblastoma: a systematic review and meta-analysis

Costantino¹,

Sebastiani²,

Russo³

et al. 2021

Rhin

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“…6,7,10,19-30 Of the articles that did not include IPD, 15 corresponding authors were contacted to provide raw data for their studies. 3,31-45 Six authors responded, and 5 provided IPD. 33,34,37,40,41,43 Nine corresponding authors did not respond after 2 inquires.…”

Section: Resultsmentioning

confidence: 99%

Comparing Kadish and Modified Dulguerov Staging Systems for Olfactory Neuroblastoma: An Individual Participant Data Meta‐analysis

Arnold

Farnoosh

Gore

2020

Otolaryngol.--head neck surg.

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Objective To compare the Kadish and the modified Dulguerov staging of individual participants to determine the impact of stage and other prognostic factors on disease-free (DFS) and overall survival (OS). Data Sources Systematic review of EMBASE, MEDLINE, Cochrane Library, and CINAHL databases. Review Methods The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) was followed for this study. Articles including patients with olfactory neuroblastoma (ONB) staged with both Kadish and Dulguerov staging systems were reviewed. The raw data from eligible studies were requested to perform an individual participant data (IPD) meta-analysis. Results Pooled data from 21 studies representing 399 patients with ONB undergoing treatment with curative intent showed that increasing age, treatment with chemotherapy, and positive or unreported margin status portended worse DFS ( P < .05). Increasing stage for both Kadish and Dulguerov staging systems was prognostic for worse DFS and OS ( P < .05), with Kadish C representing a heterogeneous group with regard to outcome and corresponding Dulguerov T stage. Using the Akaike information criterion, the Dulguerov staging system had superior performance to the Kadish system for DFS (1088.72 vs 1092.54) and OS (632.71 vs 644.23). Conclusion This study represents the first IPD meta-analysis of ONB directly comparing the outcomes of Kadish and Dulguerov staging systems in patients treated with primary surgery. Both systems correlated with DFS and OS, with superior performance in the Dulguerov system. Furthermore, the Kadish C group represented a heterogeneous group with regard to outcomes after stratification by the Dulguerov system. Dulguerov T4 patients had the worst outcome, with most being approached with open resection.

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“…Following the adoption of this technique for the resection of pituitary tumors, it was adapted for resection of extrasellar skull base lesions (6)(7)(8)(9). Fully endoscopic approaches are now in widespread use in the management of malignancies of the ventral skull base, including esthesioneuroblastoma, chordoma, and chondrosarcoma, as well as aggressive, locally invasive pathologies such as meningiomas, and craniopharyngiomas (10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Methods of Skull Base Repair Following Endoscopic Endonasal Tumor Resection: A Review

2020

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Following the introduction of fully endoscopic techniques for the resection of pituitary tumors, there was a rapid expansion of the indications for endonasal endoscopic surgery to include extrasellar tumors of the skull base. These techniques offer significant advantages over traditional open surgical approaches to the skull base, including improved tumor resection, and better post-operative neurological outcomes. Following their introduction, however, the initial rate of post-operative CSF leak was unacceptably high. Post-operative CSF leak following skull base surgery is a major source of morbidity, and can lead to the development of life-threatening intracranial infection. The use of vascularized naso-septal flaps transformed the management of these patients, significantly reducing the rate of post-operative CSF leak and increasing the number of patients that could benefit from this less invasive treatment modality. Adequate repair of iatrogenic defects in the skull base is of crucial importance for patients with skull base tumors, as the development of a post-operative CSF leak, and the associated complications can significantly delay the administration of the adjunctive oncological therapies these patients require. In this review, we provide an overview of the latest evidence regarding skull base reconstruction following endoscopic skull base surgery, and describe the skull base repair technique in use at our institution.

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Multicenter assessment of exclusive endoscopic endonasal approach for the treatment of 53 olfactory neuroblastomas

Abstract: Exclusively endoscopic treatment proved efficient and reliable in a large controlled series.

Cited by 23 publications

References 30 publications

Elective neck irradiation in the management of esthesioneuroblastoma: a systematic review and meta-analysis

Elective neck irradiation in the management of esthesioneuroblastoma: a systematic review and meta-analysis

Comparing Kadish and Modified Dulguerov Staging Systems for Olfactory Neuroblastoma: An Individual Participant Data Meta‐analysis

Methods of Skull Base Repair Following Endoscopic Endonasal Tumor Resection: A Review

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