Transnasal endoscopic surgery in selected nasal-ethmoidal cancer with suspected brain invasion: Indications, technique, and outcomes.
Adenocarcinoma
/ pathology
Adult
Aged
Brain Neoplasms
/ pathology
Carcinoma, Neuroendocrine
/ pathology
Craniotomy
Ethmoid Sinus
Feasibility Studies
Female
Humans
Male
Middle Aged
Nasal Cavity
Natural Orifice Endoscopic Surgery
Neoplasm Invasiveness
Neuroblastoma
/ pathology
Paranasal Sinus Neoplasms
/ pathology
Patient Selection
Retrospective Studies
Treatment Outcome
brain
endoscopy
ethmoid sinus
nasal cavity
neoplasms
Journal
Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
28
05
2018
revised:
02
11
2018
accepted:
12
12
2018
pubmed:
13
1
2019
medline:
11
11
2020
entrez:
13
1
2019
Statut:
ppublish
Résumé
In nasal-ethmoidal malignancies, brain involvement is associated with dismal prognosis. Patients undergoing endoscopic resection with transnasal craniectomy and subpial dissection (ERTC-SD) for brain-invading nasal-ethmoidal cancer between 2008 and 2016 were included. Complications were analyzed in all patients, whereas oncological outcomes only in patients with pathological brain invasion. The prognostic impact of previous treatments, brain edema, and histology was assessed. Hospitalization ratio was calculated. Nineteen patients received ERTC-SD and 11 had pathological-proven brain invasion. Histologies were 6 olfactory neuroblastomas (ONB), 3 neuroendocrine carcinomas, and 2 intestinal-type adenocarcinomas. Mean follow-up was 21.9 months. Three-year overall, local recurrence-free, and distance recurrence-free survivals were 65.5%, 81.8%, and 68.2%, respectively. Overall and distant recurrence-free survivals were significantly better in patients with ONB (P = 0.032 and P = 0.013, respectively). Hospitalization ratio was 4.1%. Complication rate was 10.5%. In selected nasal-ethmoidal tumors with brain invasion, ERTC-SD can provide good local control, satisfactory survival, and limited morbidity.
Sections du résumé
BACKGROUND
In nasal-ethmoidal malignancies, brain involvement is associated with dismal prognosis.
METHOD
Patients undergoing endoscopic resection with transnasal craniectomy and subpial dissection (ERTC-SD) for brain-invading nasal-ethmoidal cancer between 2008 and 2016 were included. Complications were analyzed in all patients, whereas oncological outcomes only in patients with pathological brain invasion. The prognostic impact of previous treatments, brain edema, and histology was assessed. Hospitalization ratio was calculated.
RESULTS
Nineteen patients received ERTC-SD and 11 had pathological-proven brain invasion. Histologies were 6 olfactory neuroblastomas (ONB), 3 neuroendocrine carcinomas, and 2 intestinal-type adenocarcinomas. Mean follow-up was 21.9 months. Three-year overall, local recurrence-free, and distance recurrence-free survivals were 65.5%, 81.8%, and 68.2%, respectively. Overall and distant recurrence-free survivals were significantly better in patients with ONB (P = 0.032 and P = 0.013, respectively). Hospitalization ratio was 4.1%. Complication rate was 10.5%.
CONCLUSION
In selected nasal-ethmoidal tumors with brain invasion, ERTC-SD can provide good local control, satisfactory survival, and limited morbidity.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1854-1862Informations de copyright
© 2019 Wiley Periodicals, Inc.