Risk of Delayed Lymph Node Metastasis in Clinically N0 Esthesioneuroblastoma.
ObjectiveTo determine both the rate of delayed cervical lymph node metastasis in patients with esthesioneuroblastoma (ENB) and a clinically N0 untreated neck and the effectiveness of salvage treatment.DesignRetrospective review.SettingTertiary academic medical center.ParticipantsAll patients from January 1, 1965, to December 31, 2010, who received definitive treatment for ENB.Main Outcome MeasuresThe study involved 52 patients: 27 (52%) patients underwent surgery and adjuvant radiotherapy (SART) to the primary site only and 25 (48%) underwent surgery alone (SA) as treatment of the primary site, without elective neck dissection.ResultsMedian follow-up for the SART group was 10 years versus 15.7 years for the SA group. The 10-year delayed cervical lymph node metastasis estimate is 41%. With median follow-up of 47 months after salvage treatment, the 4-year cervical lymph node recurrence-free survival estimate is 70%; the 5-year overall survival estimate is 39%.ConclusionsDelayed cervical lymph node metastases are common, indolent, and salvaged effectively in most patients. We propose that patients with ENB and clinically N0 cervical lymph nodes may choose to forego elective neck dissection or elective neck radiotherapy in favor of neck observation within their initial treatment.
Mayo Medical School, Mayo Clinic College of Medicine, Rochester, Minnesota, United States.
Justin G
JG
Peacock
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States.
William S
WS
Harmsen
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States; Department of Otorhinolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States.
Michael J
MJ
Link
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States; Department of Otorhinolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States.
Jamie J
JJ
Van Gompel
Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota, United States.
Caterina
C
Giannini
Department of Otorhinolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States.
Kerry D
KD
Olsen
Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States.
Yolanda I
YI
Garces
Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States; Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States.
Michelle A
MA
Neben Wittich
Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States.
Daniel J
DJ
Ma
Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States.
Sean S
SS
Park
Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States.
Robert L
RL
Foote
cervical lymph node metastasis; esthesioneuroblastoma; radiotherapy; surgery