53例嗅神经母细胞瘤的单纯鼻内镜鼻内入路治疗的多中心评估
Multicenter assessment of exclusive endoscopic endonasal approach for the treatment of 53 olfactory neuroblastomas.
作者信息
de Gabory Ludovic, Verillaud Benjamin, Rumeau Cécile, Herman Philippe, Jankowski Roger, Michel Justin, de Kermadec Héloïse, Coste André, Mortuaire Geoffrey, Righini Christian, Reyt Emile, Choussy Olivier, Trévillot Vincent, Crampette Louis, Serrano Elie, Tsaranazy Anjarasoa, Bastier Pierre-Louis, Vergez Sebastien
机构信息
Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Pellegrin, Bordeaux, France.
Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Lariboisière, Paris, France.
出版信息
Head Neck. 2018 May;40(5):1000-1007. doi: 10.1002/hed.25064. Epub 2018 Jan 22.
BACKGROUND
Given the particularities of olfactory neuroblastoma (ONB) and the lack of studies on the subject, a multicenter collaborative study was conducted to assess treatment strategy.
METHODS
Fifty-three patients with ONB were included from the French Rare Head and Neck Cancer Expert Network (REFCOR) database: 16T1, 8T2, 19T3, and 10T4. All cases were treated endoscopically with skull base removal and repair in 26 cases (49%) and without external craniotomy.
RESULTS
The overall survival (OS) and disease-free survival (DFS) rates at 5 years were 87% and 71%, respectively, with mean follow-up of 45.4 ± 26.5 months. The complication rate was 18.8% with 4 cases of meningitis. Pathological analysis showed positive margins in 26.8%, notably on the dura-mater and periorbita, without impairment of OS or DFS. Forty-eight patients received adjuvant radiotherapy on T ± N. Ten patients had a recurrence (18.9%). Six patients died of their disease. Prophylactic neck irradiation seemed to reduce the recurrence rate.
CONCLUSION
Exclusively endoscopic treatment proved efficient and reliable in a large controlled series.
背景
鉴于嗅神经母细胞瘤（ONB）的特殊性以及该领域研究的匮乏，开展了一项多中心合作研究以评估治疗策略。
方法
从法国罕见头颈癌专家网络（REFCOR）数据库纳入53例ONB患者：16例T1期、8例T2期、19例T3期和10例T4期。所有病例均采用内镜治疗，26例（49%）进行了颅底切除和修复，未行开颅手术。
结果
5年总生存率（OS）和无病生存率（DFS）分别为87%和71%，平均随访时间为45.4±26.5个月。并发症发生率为18.8%，4例发生脑膜炎。病理分析显示切缘阳性率为26.8%，主要在硬脑膜和眶周，未影响OS或DFS。48例患者接受了T±N辅助放疗。10例患者复发（18.9%）。6例患者死于疾病。预防性颈部放疗似乎可降低复发率。
结论
在大型对照系列研究中，单纯内镜治疗被证明是有效且可靠的。
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