Affiliation:
1. Department of Otorhinolaryngology,
All India Institute of Medical Sciences, New
Delhi
2. Department of Pathology, All India
Institute of Medical Sciences, New
Delhi
Abstract
Abstract
Objective: Although till date no
management protocol for esthesioneuroblastoma
(ENB) has been standardized due to tumor rarity,
still multimodality approach shows better
treatment outcomes as compared to surgery alone.
The objective of this study was to analyze the
clinicopathological spectrum of ENB and to
correlate treatment response with tumor staging,
histopathological grading, and various treatment
modalities. Materials and Methods: Twenty-one
consecutive patients with biopsy-proven ENB were
studied and evaluated for response to treatment in
the form of complete tumor resolution. Results
were analyzed and correlated with stage and grade
of tumor and form of therapy received. Results:
There was male preponderance (3.2:1) with age
ranging between 7 and 63 years (median of 25
years). Survival rates significantly dropped with
increasing tumor stage (63.6% in stages A and B
vs. 30% in stages C and D) and grade (100% in
Grades 1 and 2 vs. 31.25% in Grades 3 and 4). The
recurrence rate was 80% in surgery alone group,
which came down to 43.7% if surgery was
supplemented with other modalities. In cases where
multimodality treatment plan was used, endoscopic
procedures fared equally as open surgical
procedures. Conclusion: Hyam’s grade and Kadish
stage are important prognostic indicators of
treatment outcome, with survival rates dropping
with increasing tumor stage and grade.
Multimodality treatment protocols have improved
the disease outcome, making endoscopic surgery
equivalent to radical surgeries regarding result
outcomes and giving other advantages such as
better cosmesis, less treatment-related
morbidities, decreased hospital stay, and better
cost-effectiveness.
Cited by
5 articles.
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