Esthesioneuroblastoma: the role of post-operative irradiation after complete surgical resection

Esthesioneuroblastoma is a rare tumor and this retrospective report was done to evaluate the role of post-operative radiotherapy after complete surgical resection of the tumor.

Twenty nine patients with Esthesioneuroblastoma of Kadish stages A (1), B (19), C (6) and unknown (3) were retrospectively identified through the hospital data-base, patients charts, imaging studies and computerized notes between 1995 to 2007 at Department of Radiation Oncology, University of Michigan, U.S.A.

After complete surgical resection (mostly craniofacial resection) of the tumor, 13 (44.8%) patients received post-operative radiotherapy to the tumor bed and 16 (45.2%) patients did not receive. Only one patient received adjuvant nodal irradiation. At a median followup 80 months, local recurrence developed in 11 of 16 (68.7%) patients in the group which did not receive postoperative radiotherapy, compared with 2 of 13 (15.3%) patients in the group which received. Disease free cumulative survival rate at 5-years was 88% for the group which received post-operative radiotherapy compared with 35% for the group which did not receive (p=0.02). Lymph node recurrence in retropharyngeal and level II nodes was observed in 7 (24%) patients of whole group.

Adjuvant radiotherapy to the tumor bed after craniofacial resection improves significantly local control and disease free survival. Our results suggest that in addition to the tumor bed, prophylactic irradiation of the upper neck is necessary in patients with Kadish stages B and C.

Esthesioneuroblastoma - Radiotherapy - Surgery.