Relationships of radiological and surgical variables and vascular endothelial growth factor expression with recurrence in juvenile nasopharyngeal angiofibroma

Abstract

Juvenile nasopharyngeal angiofibroma (JNA) is a rare fibrovascular tumor that is histologically benign but clinically invasive and it is typified by a high recurrence rate. The recurrence rate is influenced by several characteristics including sociodemographic, clinical, radiological, and surgical variables and vascular endothelial growth factor (VEGF) expression. This observational retrospective cohort study aimed to clarify the relationships of these characteristics with the risk of recurrence in 38 male patients with JNA, including 11 patients with recurrence. JNA commonly develops in the second decade of life with a mean age of occurrence of 15.8 years. Nasal blockage and epistaxis were the most common complaints. Young age, early onset, late-stage disease, and high VEGF expression were linked to higher recurrence rates, albeit without significance. Meanwhile, the age of onset, the presence of an oropharyngeal mass, tumor stage, the use of preoperative embolization, and the intensity of VEGF staining appeared to have clinical significance regarding the risk of recurrence. In this study, preoperative embolization did not decrease the recurrence rate. The risk of recurrence was increased by the presence of residual tumor, suggesting that measures should be taken to ensure complete tumor resection during surgery.