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嗅神经母细胞瘤:单机构25年经验

Esthesioneuroblastoma: 25-year experience at a single institution.

作者信息

Zafereo Mark E, Fakhri Samer, Prayson Richard, Batra Pete S, Lee Joung, Lanza Donald C, Citardi Martin J

机构信息

Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA.

出版信息

Otolaryngol Head Neck Surg. 2008 Apr;138(4):452-8. doi: 10.1016/j.otohns.2007.12.038.

Abstract

OBJECTIVES

To evaluate outcomes for patients with esthesioneuroblastoma treated at a single institution during a 25-year period.

DESIGN

Eighteen patients with pathologic diagnosis of esthesioneuroblastoma between 1980 and 2004 were retrospectively identified.

RESULTS

Two patients had Kadish A, seven had Kadish B, and nine had Kadish C disease. The mean follow-up was 71 months. Treatment regimens consisted of surgery alone (four patients), surgery followed by postoperative radiation (six patients), surgery followed by postoperative chemoradiotherapy (three patients), preoperative radiotherapy (two patients), preoperative chemoradiotherapy (one patient), chemoradiotherapy (one patient), and surgery plus chemotherapy (one patient). Surgical approaches (n = 17) consisted of 13 traditional craniofacial resections, one endoscopic-assisted cranionasal resection, and three minimally invasive endoscopic resections. The 10-year disease-specific survival was 80%. The overall recurrence-free survival at five and 10 years was 62% and 46%, respectively. Positive surgical margins and TNM staging predicted survival.

CONCLUSION

Both endoscopic and open surgical approaches have been successful in treating a small number of esthesioneuroblastoma patients with high survival and low rate of surgical complications.

摘要

目的

评估在一家机构接受治疗的嗅神经母细胞瘤患者25年间的治疗结果。

设计

回顾性确定了1980年至2004年间18例经病理诊断为嗅神经母细胞瘤的患者。

结果

2例为卡迪什A期,7例为卡迪什B期,9例为卡迪什C期。平均随访时间为71个月。治疗方案包括单纯手术(4例患者)、手术后放疗(6例患者)、手术后放化疗(3例患者)、术前放疗(2例患者)、术前放化疗(1例患者)、放化疗(1例患者)以及手术加化疗(1例患者)。手术方式(n = 17)包括13例传统颅面切除术、1例内镜辅助颅鼻切除术和3例微创内镜切除术。10年疾病特异性生存率为80%。5年和10年的总体无复发生存率分别为62%和46%。手术切缘阳性和TNM分期可预测生存率。

结论

内镜手术和开放手术在治疗少数嗅神经母细胞瘤患者方面均取得成功,生存率高且手术并发症发生率低。

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