Comparison of Open and Endoscopic Approaches in the Resection of Esthesioneuroblastoma.
| Autor: | Barinsky, Gregory L., Azmy, Monica C., Kilic, Suat, Grube, Jordon G., Baredes, Soly, Hsueh, Wayne D., Eloy, Jean Anderson |
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| Předmět: |
PARANASAL sinus surgery
CHI-squared test COMPARATIVE studies ENDOSCOPY LENGTH of stay in hospitals OPERATIVE otolaryngology PARANASAL sinus cancer POSTOPERATIVE period PREOPERATIVE care STATISTICAL sampling SURVIVAL analysis (Biometry) MULTIPLE regression analysis TREATMENT effectiveness DESCRIPTIVE statistics KAPLAN-Meier estimator OLFACTORY esthesioneuroblastoma |
| Zdroj: | Annals of Otology, Rhinology & Laryngology; Feb2021, Vol. 130 Issue 2, p136-141, 6p |
| Abstrakt: | Background: Olfactory neuroblastoma, or esthesioneuroblastoma (ENB), is an uncommon sinonasal malignancy arising from olfactory neuroepithelium that is optimally treated with surgical resection. The objective of this study is to determine preoperative predictors of undergoing open versus endoscopic approach for ENB and to investigate significant postoperative survival outcomes between the two surgical approaches. Methods: The National Cancer Database (NCDB) was queried for cases of ENB histology that were treated surgically from 2010 to 2015. Groups were stratified into open or endoscopic approach cohorts. Patient demographics, tumor characteristics, treatment modality, and 5-year overall survival were compared between the two groups using Chi-Square analysis and Kaplan-Meier survival analysis. Cases were classified as Kadish stage A, B, C, or D based on the "Collaborative Stage-Extension" codes in NCDB. Results: Of 533 patients meeting inclusion criteria, 276 (51.8%) patients underwent open, and 257 (48.2%) patients underwent endoscopic surgical approaches. Patients undergoing endoscopic surgery were more likely to be Kadish stages A and B and less likely to be stages C and D (P =.020). Those undergoing endoscopic approach overall had a shorter mean hospital stay postoperatively (3.8 vs. 7.0 days, P <.001). Endoscopic cases had a greater 5-year overall survival (81.9% vs. 75.6%, P =.030); after multivariate regression, there was a trend toward survival benefit to endoscopic surgery that did not reach clinical significance (HR 0.644, [0.392-1.058], P =.083). Conclusion: Although not statistically significant, there is a trend toward increased overall survival with an endoscopic approach in patients undergoing surgery for ENB as compared to an open approach, regardless of Kadish stage. An endoscopic approach is an adequate alternative to an open approach for the surgical treatment of ENB. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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