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

Abstract

4. Laryngoscope, 128:864-870, 2018.

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.…”

“…This data is also consistent with other work demonstrating that the level II lymph node basin is the most common site of metastasis. 14,15,19 Furthermore, more than half of patients with nodal disease had multilevel involvement, which is also consistent with the findings reported by Banuchi et al 15 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. At this point, no recommendation can be made about elective neck dissection or radiation therapy for the N0 neck, although continued surveillance for future development of metastatic disease would be crucial in gaining longterm disease control.…”

“…Thus, it is possible that the four‐tiered tumor grading system as listed does not necessarily correlate with the four‐tiered Hyams grading system, although a previous SEER study established a robust relationship between tumor grade and survival in ENB. Fourth, though uncommon, ENBs may metastasize to the contralateral neck, and this information is not included in the SEER database . Fifth, SEER does not specify laterality for malignancies, especially in consideration of differing strategies between treatment of unilateral and bilateral ENB .…”

“…Fourth, though uncommon, ENBs may metastasize to the contralateral neck, and this information is not included in the SEER database. 19,22 Fifth, SEER does not specify laterality for malignancies, especially in consideration of differing strategies between treatment of unilateral and bilateral ENB. 23 Ultimately, prospective multi-institutional studies evaluating various surgical and radiotherapy approaches should be considered to determine the optimal strategy to treatment of the N0 neck.…”

ICAR: endoscopic skull‐base surgery

“…In studies with smaller populations, the rate of regional metastasis has been found to be >20% and thus a case could be made for elective treatment of the neck. Incidence of delayed regional metastasis has been highly variable in the literature; however, low patient numbers have been a major limitation of many of these studies (Table …”