Esthesioneuroblastoma: continued follow-up of a single institution's experience.
OBJECTIVE
To analyze outcomes and to provide follow-up for our increasing patient cohort with esthesioneuroblastoma.


METHODS
Retrospective cohort analysis.


METHODS
Patients were examined from September 1, 1976, to May 30, 2004, in a tertiary care academic hospital.


METHODS
Fifty consecutive patients diagnosed as having esthesioneuroblastoma were treated with a standardized protocol during a 28-year period. Patients with tumors staged Kadish A or B received preoperative radiotherapy followed by craniofacial resection, while patients with Kadish stage C disease were treated with preoperative sequential chemotherapy and radiotherapy followed by a craniofacial resection. The mean follow-up is 93 months (range, 1-330 months).


RESULTS
The disease-free survival was 86.5% and 82.6% at 5 and 15 years, respectively. There were 17 patients (34%) who developed recurrent disease, most of which was locoregional (12 patients [71%]). There was a long interval to relapse (mean, 6 years), with the longest time to regional recurrence being 10 years. Distant relapses occurred sooner, with poorer outcomes. Of these 17 patients, 7 (41%) underwent successful salvage surgery, while 3 remain alive with disease.


CONCLUSIONS
Excellent outcomes for esthesioneuroblastoma are achievable. Long-term follow-up is necessary because of the extended interval for recurrent disease; unlike most sinonasal malignancies, surgical salvage is possible.
Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville 22908-0713, USA.
Andrew H
AH
Loy
James F
JF
Reibel
Paul W
PW
Read
Christopher Y
CY
Thomas
Steven A
SA
Newman
John A
JA
Jane
Paul A
PA
Levine
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D018304:Esthesioneuroblastoma, Olfactory / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures / Q000379:methods*; D009669:Nose Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide