Salvage Treatment of Late Neck Metastasis in Esthesioneuroblastoma

Abstract

Treatment of neck metastases occurring 6 or more months after an initial diagnosis of ENB with combined surgery and radiotherapy provides a statistically significant survival advantage vs single-modality therapy.

Esthesioneuroblastoma Treated with Endoscopic Craniofacial Resection: A Report of a Case

“…Esthesioneuroblastoma is a relatively uncommon tumor of the nasal modality treatment of neck metastases demonstrated a statistically significant survival benefit over radiation alone or neck dissection alone [6,12,14]. Salvage of local recurrence has also been studied in patients with esthesioneuroblastoma, but a meta-analysis failed to demonstrate superiority of salvage surgery + radiation over surgery alone or radiation alone for local recurrence [15].…”

“…Positive surgical margins, advanced Kadish or T stage, and cervical or distant metastases are correlated with decreased survival. Studies have shown that patients with cervical metastasis can benefit from salvage with neck dissection and post-operative neck irradiation [12]. In patients requiring skull base resection a multilayer repair of the skull base, preferably with a vascularized flap such as the nasoseptal flap, decreases the risk of postoperative CSF leak [13].…”

Olfactory Neuroblastoma Treated by Minimally Invasive Endoscopic Resection and Postoperative Adjuvant Radiotherapy: A Representative Case and an Updated Review of the Literature

“…However, in several different reviews and metaanalyses of the largest and most recent series the overall rate of synchronous and metachronous cervical metastases is reported to be between 20.2% and 23.4% [26][27][28][29]. Gore et al [28] state that 62% of cervical metastases occur 6 or more months after primary treatment.…”

“…Gore et al [28] state that 62% of cervical metastases occur 6 or more months after primary treatment. Moreover, the presence of such metastases is usually related to the development of distant metastases and poor prognosis, in general [26,28].…”

“…Gore et al [28] state that 62% of cervical metastases occur 6 or more months after primary treatment. Moreover, the presence of such metastases is usually related to the development of distant metastases and poor prognosis, in general [26,28]. Therefore, the vast majority of the recent studies support that neck metastases should be treated by neck dissection and radiotherapy: in the meta-analysis of Dulguerov et al survival data demonstrated that only 29% of initially N+ patients were treated successfully, compared with 64% of the N0 patients [17].…”