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.
Key words
Endoscopic excision - esthesioneuroblastoma - radiotherapy - surgery