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Continued Follow-up of a Single Institution's Experience

Andrew H. Loy, FRCS; James F. Reibel, MD; Paul W. Read, MD; Christopher Y. Thomas, MD; Steven A. Newman, MD; John A. Jane, MD; Paul A. Levine, MD

Arch Otolaryngol Head Neck Surg. 2006;132:134-138.

Objectives  To analyze outcomes and to provide follow-up for our increasing patient cohort with esthesioneuroblastoma.

Design  Retrospective cohort analysis.

Setting  Patients were examined from September 1, 1976, to May 30, 2004, in a tertiary care academic hospital.

Patients  Fifty consecutive patients diagnosed as having esthesioneuroblastoma were treated with a standardized protocol during a 28-year period. Patients with tumors staged Kadish A or B received preoperative radiotherapy followed by craniofacial resection, while patients with Kadish stage C disease were treated with preoperative sequential chemotherapy and radiotherapy followed by a craniofacial resection. The mean follow-up is 93 months (range, 1-330 months).

Results  The disease-free survival was 86.5% and 82.6% at 5 and 15 years, respectively. There were 17 patients (34%) who developed recurrent disease, most of which was locoregional (12 patients [71%]). There was a long interval to relapse (mean, 6 years), with the longest time to regional recurrence being 10 years. Distant relapses occurred sooner, with poorer outcomes. Of these 17 patients, 7 (41%) underwent successful salvage surgery, while 3 remain alive with disease.

Conclusions  Excellent outcomes for esthesioneuroblastoma are achievable. Long-term follow-up is necessary because of the extended interval for recurrent disease; unlike most sinonasal malignancies, surgical salvage is possible.

Author Affiliations: Departments of Otolaryngology–Head and Neck Surgery (Drs Loy, Reibel, and Levine), Radiation Oncology (Dr Read), Internal Medicine (Dr Thomas), Ophthalmology (Dr Newman), and Neurological Surgery (Dr Jane), University of Virginia Health System, Charlottesville. Dr Loy is now with the Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore.