Abstract
BackgroundThe aim of this study is to evaluate the efficacy of different treatment strategies and the potential prognostic factors of esthesioneuroblastoma (ENB).Materials and methodsBetween April 1984 and December 2018, 138 patients with non-metastatic ENB were retrospectively analyzed. The treatment modalities mainly included surgery alone (n = 7), radiotherapy alone (n = 33), concurrent chemoradiotherapy (n = 17), surgery combined with current chemoradiotherapy (n = 32), and surgery plus radiotherapy (n = 49).ResultsThe median follow-up time for the entire cohort was 61 months (range, 4–231 months). The 5-year overall survival (OS), locoregional failure-free survival (LRFFS), and distant metastasis-free survival (DMFS) rate were 69.6, 78.0 and 73.9%, respectively. Surgery combined with radiotherapy elicited superior survival results, and the combination of surgery and current chemoradiotherapy achieved the best prognoses for all patients, patients with advanced Kadish disease, patients receiving intensity modulated radiation therapy and those with positive surgical margin. Univariate analysis identified orbital invasion and treatment modalities were predictors for OS, LRFFS and DMFS. Lymph node metastasis was associated with OS and DMFS, but not LRFFS. Intracranial invasion, advanced Kadish stage and not receiving concurrent chemotherapy were also predictive of lower OS. Multivariate analyses indicated that lymph node metastasis was an independent prognostic factor affecting DMFS, whereas treatment modalities was independent prognostic factors for OS and LRFFS.ConclusionOrbital invasion, intracranial invasion, lymph node metastasis and advanced Kadish disease at initial diagnosis were significantly associated with inferior prognosis. Regarding the treatment modality, the optimal strategy remined surgery with radiotherapy-based multimodality treatment. The concurrent chemoradiotherapy may play a more beneficial role.
Highlights
The aim of this study is to evaluate the efficacy of different treatment strategies and the potential prognostic factors of esthesioneuroblastoma (ENB)
We aimed to evaluate the efficacy of different treatment strategies and the potential prognostic factors of patients with non-metastatic ENB
Disease in all patients was reclassified according to the Kadish stage on the basis of surgical records, clinical documents and imaging findings, which included X-radiography, computed tomography (CT) or magnetic resonance imaging (MRI) images, and 133 patients underwent CT or MRI
Summary
The aim of this study is to evaluate the efficacy of different treatment strategies and the potential prognostic factors of esthesioneuroblastoma (ENB). Esthesioneuroblastoma (ENB) is an uncommon malignant neoplasm which accounts for only 3 to 6% of all cancers in the nasal cavity and paranasal sinuses. No consensus regarding its uniform staging system and optimal treatment strategy has been reached. The most widely used classification was proposed by Kadish et al in 1976 [5]. In this classification, stage C was defined as tumor spread beyond the nasal cavity and paranasal sinuses. Given the rarity of this disease, the optimal treatment strategies were mainly derived from single-institution retrospective studies or population-based analyses. Surgery combined with radiotherapy was frequently considered as the standard of care in the previous studies and the role of chemotherapy remained controversial [6,7,8,9]
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