Otolaryngology: Open Access
Open Access

Abstract

Olfactory neuroblastoma (ONB) or esthesioneuroblastoma is a rare malignancy of sinonasal cavity; consequently there is no defined treatment protocol. The expanded role of endoscopic skull base surgery has stimulated increased use of primary surgical resection of selected tumors. The purpose of this study is to report the experience of a single head and neck surgeon with the treatment and patterns of failure of this disease over an 18 year period. From 1994 to 2012, 37 previously unreported patients with olfactory neuroblastoma were evaluated and 32 eventually treated for cure at 2 academic medical centers. All patients were staged with both TNM and Kadish criteria. The mean and median follow-ups were 96.1 and 76.5 months respectively (range 6-240 months). The Kadish stage was A in 6 patients, B in 13 patients and C in 13 patients. Four patients were initially treated with concurrent chemo-radiation therapy. Twenty-eight patients were treated with primary surgery. Two (2) underwent open medial maxillectomy and 26 underwent craniofacial resection (open-17, endoscopic-9). Three patients received curative surgical resection only. Seven patients failed either within the cranial axis or distantly, 6 of the 7 are dead of disease, 10 to 194 months following initial treatment. Six patients had isolated neck recurrences, 4/6 were salvaged with neck dissection and additional chemo-radiation and remained alive for 30 to 194 months following initial treatment. Estimated overall survival rate at 10 years was 78% based on Kadish and T stage. In this retrospective analysis of 32 patients, Kadish stage C and stage T3/T4 tumors were associated with worse outcome. Total radiation dose of 60 Gy, margin status, patient age were not found to have significant prognostic value.

Biography

Email: guypetruzzelli@memorialhealth.org