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嗅神经母细胞瘤鼻内镜手术的临床分析

[Clinical analysis of endonasal endoscopic surgery in esthesioneuroblastoma].

作者信息

Gu Yuelong, Mao Song, Tang Ru, Li Zhipeng, Zhang Weitian

机构信息

Department of Otolaryngology Head and Neck Surgery,Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital,Shanghai,200233,China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Jun;38(6):503-507. doi: 10.13201/j.issn.2096-7993.2024.06.009.

Abstract

To investigate the clinical characteristics of esthesioneuroblastoma and the efficacy of endonasal endoscopic surgery combined with radiotherapy/chemotherapy. The clinical and surgical data of 17 patients with esthesioneuroblastoma who underwent endonasal endoscopic surgery in our department from September 2009 to June 2023 were retrospectively analyzed. Among all patients, the modified Kadish stage B was identified in 4 patients, C in 10 patients, and D in 3 patients. Ten of them underwent endonasal endoscopic surgery without neck dissection in one day, whose average operation time is (5.2±2.5) hours and average blood loss is (192±162)mL. Skull base reconstructions were performed in 15 patients, postoperative complications were observed in 3 patients, and negative margins were obtained in 13 patients. All 17 patients were followed up for an average of (49.7±40.2) months. Three patients died and 6 had recurrence and/or metastasis. The 1-year, 2-year and 5-year overall survival rates were 88.2%, 80.2%, and 80.2%, respectively, and the 1-year, 2-year and 5-year disease-free survival rates were 82.4%, 82.4%, and 50.8%, respectively. The 2-year overall survival rates of patients with negative and positive margins were 100% and 25%, respectively, while the 2-year disease-free survival rates were 61.5% and 25.0%, respectively. Endonasal endoscopic surgery combined with radiotherapy/chemotherapy can achieve satisfactory effect in esthesioneuroblastoma, and the prognosis of patients with positive margins is poor.

摘要

探讨嗅神经母细胞瘤的临床特征及鼻内镜手术联合放疗/化疗的疗效。回顾性分析2009年9月至2023年6月在我科接受鼻内镜手术的17例嗅神经母细胞瘤患者的临床及手术资料。所有患者中,改良Kadish分期B期4例,C期10例,D期3例。其中10例患者于1日内接受鼻内镜手术且未行颈部清扫,平均手术时间为(5.2±2.5)小时,平均出血量为(192±162)mL。15例患者行颅底重建,3例观察到术后并发症,13例患者切缘阴性。17例患者均获随访,平均随访时间为(49.7±40.2)个月。3例患者死亡,6例出现复发和/或转移。1年、2年和5年总生存率分别为88.2%、80.2%和80.2%,1年、2年和5年无病生存率分别为82.4%、82.4%和50.8%。切缘阴性和阳性患者的2年总生存率分别为100%和25%,2年无病生存率分别为61.5%和25.0%。鼻内镜手术联合放疗/化疗治疗嗅神经母细胞瘤可取得满意疗效,切缘阳性患者预后较差。

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