Spread patterns of lymph nodes and the value of elective neck irradiation for esthesioneuroblastoma

A Population‐Based Analysis of Nodal Metastases in Esthesioneuroblastomas of the Sinonasal Tract

“…Based on the results, the current study suggests that the overall incidence of cervical lymph node metastases at the time of diagnosis of ENB is quite rare (less than 10%). This data is also consistent with other work demonstrating that the level II lymph node basin is the most common site of metastasis . Furthermore, more than half of patients with nodal disease had multilevel involvement, which is also consistent with the findings reported by Banuchi et al Given this low incidence of nodal disease, it is not surprising to understand the difficulty in developing standardized guidelines for management of the N0 neck in ENB.…”

“…Although advances in endoscopic endonasal approaches and radiotherapy have improved treatment options for patients, risk of locoregional or distant treatment failure remains high for some years following initial treatment. Prior studies have suggested that the presence of cervical lymph node metastases negatively impacts overall survival . However, a thorough understanding of the lymphatic spread patterns of ENB is currently lacking, and many studies have advocated different approaches to elective treatment of the N0 neck .…”

“…Prior studies have suggested that the presence of cervical lymph node metastases negatively impacts overall survival . However, a thorough understanding of the lymphatic spread patterns of ENB is currently lacking, and many studies have advocated different approaches to elective treatment of the N0 neck . Studies on the incidence of lymph node metastases have varied in the literature, with earlier work reporting rates of 5% to 17% .…”

Volumetric analysis of olfactory neuroblastoma skull base laterality and implications on neck disease

“…Ten‐year disease‐specific survival drops from 90% to 36% for patients with cervical lymph node metastasis compared to patients with disease limited to the nasal cavity . Because of these prognostic consequences, studies have investigated the role of elective neck treatment in the clinically negative neck . However, despite the critical implications of neck disease in ONB, relatively few studies have reported the patterns of nodal spread.…”

“…Emerging research addressing this question observes level II lymph nodes to be the most frequently involved, followed by levels I and III. Retropharyngeal lymph node involvement has been described, although its frequency is inconsistently demonstrated …”