Survival outcomes for stage-matched endoscopic and open resection of olfactory neuroblastoma
Survival outcomes for stage-matched endoscopic and open resection of olfactory neuroblastoma
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DOI：
10.1002/hed.24912
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发表时间：
2017-12-01
影响因子：
2.9
通讯作者：
Gallagher, Richard
中科院分区：
文献类型：
--
作者：
Harvey, Richard J.;Nalavenkata, Sunny;Gallagher, Richard
背景：晚期嗅神经母细胞瘤需要多模式治疗以获得最佳结果。在这种情况下，内窥镜鼻内手术存在争议。比较分期匹配的开放和内镜手术治疗。方法：对来自6家肿瘤机构的患者进行评估。分层包括硬脑膜受累、Kadish分期、淋巴结疾病、Hyams分级、入路和切缘状况。在随访中，记录局部控制、淋巴结状态和远处转移的证据。进行统计学分析以确定复发和生存差异的危险因素。结果：109例患者（年龄49.2 +/- 13.0岁，46%为女性）分别为卡迪什A期（10%）、卡迪什B期（25%）和卡迪什C期（65%）。大多数患者（61.5%）行内镜切除，53.5%为卡迪什C期。期内生存分析有利于内镜亚组治疗卡迪什C期（log-rank P = 0.017），而卡迪什B期无统计学意义（log-rank P = 0.39）。结论：内镜治疗组的分期匹配生存率优于开放手术组，获得了较高的阴性切缘。
Background: Advanced-stage olfactory neuroblastoma requires multimodal therapy for optimal outcomes. Debate exists over endoscopic endonasal surgery in this situation. Stage-matched open and endoscopic surgical therapy were compared.Methods: Patients from 6 cancer institutions were assessed. Stratification included dural involvement, Kadish stage, nodal disease, Hyams' grade, approach, and margin status. At follow-up, local control, nodal status, and evidence of distant metastases were recorded with any subsequent therapy. Statistical analyses to identify risk factors for developing recurrence and survival differences were performed.Results: One hundred nine patients were assessed (age 49.2 +/- 13.0 years; 46% women) representing Kadish A stage (10%), Kadish B stage (25%), and Kadish C stage (65%). The majority of the patients (61.5%) underwent endoscopic resection, 53.5% within Kadish C stage. Within-stage survival analysis favored endoscopic subgroup for Kadish C stage (log-rank P = .017) nonsignificant for Kadish B stage (log-rank P = .39).Conclusion: Stage-matched survival was better for the endoscopically treated group compared to the open surgery group, with high negative margin resections obtained.