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Published on: July 5, 2021
Surgical Management of Esthesioneuroblastoma at a Single Tertiary Care Center
Evan J Patel1, Christine Glastonbury2, Annemieke van Zante3
1Department of Otolaryngology-Head & Neck Surgery, University of California San Francisco, San Francisco, California, United States.
Objectives:
To analyze management strategies and outcomes for patients with esthesioneuroblastoma (ENB) undergoing surgical resection at a single institution.
Methods:
Retrospective review from 1971 to 2022 from a single, high-volume tertiary academic center of all patients with ENB.
Results:
A total of 60 patients received their primary treatment for ENB at our institution. The average age at diagnosis was 52 years (range 13-91), and most were male (66.7%) with Kadish C (61.7%) stage at presentation. Most patients were treated with an open approach (68.3%) compared with a purely endoscopic approach (31.7%). Median follow-up was 96.9 months (mean 118.8 months, interquartile range 28.4-183.8 months). There was one patient with local recurrence in the endoscopic cohort (5.3%) compared with 22.0% (9 patients) among those who underwent an open resection ( p = 0.21). The 5-year survival was 87.2% (95% CI, 71.9-100.0%) in the endoscopic cohort compared with 80.2% (95% CI, 68.8-93.5%) in the open group ( p = 0.60). The rate of death or recurrence within 5 years of treatment was comparable between open and endoscopic (32.5% vs. 15.0%, p = 0.26). Among Kadish C patients treated in the endoscopic era (after 2006), 5-year survival was 76.2% (95% CI, 52.1-100.0%) in the endoscopic cohort and 64.8% (95% CI, 39.3-100.0%) in the open group ( p = 0.70).
Conclusion:
The surgical approach for ENB resection is dictated by tumor extension. Endoscopic resection offers a less invasive approach with comparable postoperative outcomes in appropriately selected patients.
