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Patterns of failures after surgical resection in olfactory neuroblastoma

 Nalee Kim  ;  Chang Geol Lee  ;  Eui Hyun Kim  ;  Chang-Hoon Kim  ;  Ki Chang Keum  ;  Kyu-Sung Lee  ;  Jong Hee Chang  ;  Chang-Ok Suh 
 Journal of Neuro-Oncology, Vol.141(2) : 459-466, 2019 
Journal Title
 Journal of Neuro-Oncology 
Issue Date
Craniofacial resection ; Endoscopy ; Head and neck cancer ; Olfactory neuroblastoma ; Survival
INTRODUCTION: Patterns of failure in patients with olfactory neuroblastoma (ONB) according to two surgical approaches, craniofacial resection (CFR) and endoscopic surgery (ENDO), have yet to be analyzed. METHODS: We retrospectively reviewed 28 patients with surgically treated ONB between January 1995 and October 2017. Fourteen (50.0%) patients underwent CFR (9 CFR alone, 5 ENDO-assisted CFR) and 14 (50.0%) underwent ENDO. Nineteen (67.9%) patients underwent post-operative radiotherapy (RT). RESULTS: At a median follow-up of 53.8 months (range 10.4-195.3), the 5-year progression-free survival (PFS) and 10-year overall survival were 37.3% and 57.5%, respectively. Patients with adjuvant RT had a 5-year PFS of 46.7%, whereas those treated with surgery alone had a 5-year PFS of 19.4% (p = 0.01). Locoregional failure (LRF) occurred in ten patients (median 59.6 months after initial diagnosis; range 12.7-59.7). Neck node metastasis occurred in 25.0% (7 of 28). Five patients with ENDO showed LRF and underwent proper subsequent treatments with either surgery or adjuvant RT. Approximately 35.7% patients (five patients) in the CFR group experienced distant metastasis in the intracranial dura region (median 116.4 months after initial diagnosis; range 2.6-142.4). Three of four patients who developed LRF after CFR developed dura-based metastasis. CONCLUSIONS: Both dura-based and neck node metastasis in the delayed phase were distinct patterns of failure in ONB. Patterns of recurrence differed based on surgical approach; dura-based metastases were common after CFR. LRF was the distinct failure pattern in ENDO, but could be successfully salvaged. Treatment outcome was improved considerably with RT following surgical resection.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
금기창(Keum, Ki Chang) ORCID logo https://orcid.org/0000-0003-4123-7998
김의현(Kim, Eui Hyun) ORCID logo https://orcid.org/0000-0002-2523-7122
김창훈(Kim, Chang Hoon) ORCID logo https://orcid.org/0000-0003-1238-6396
서창옥(Suh, Chang Ok)
이규성(Lee, Kyu Sung)
이창걸(Lee, Chang Geol) ORCID logo https://orcid.org/0000-0002-8702-881X
장종희(Chang, Jong Hee)
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