OBJECTIVES: To analyze management strategies and outcomes for patients with Esthesioneuroblastoma (ENB) undergoing surgical resection at a single institution.
METHODS: Retrospective review from 1971-2022 from a single high-volume tertiary academic center of all patients with ENB.
RESULTS: A total of 60 patients received their primary treatment for ENB at our institution. The average age at diagnosis was 52 years (range 13-91), and most were male (66.7%) with Kadish C (61.7%) stage at presentation. Most patients were treated with an open approach (68.3%) compared to a purely endoscopic approach (31.7%). Median follow-up was 96.9 months (mean 118.8 months, interquartile range 28.4 – 183.8 months). There was one patient with local recurrence in the endoscopic cohort (5.3%) compared to 22.0% (9 patients) among those who underwent an open resection (p = 0.21). Five-year survival was 87.2% (95% CI, 71.9%-100.0%) in the endoscopic cohort compared to 80.2% (95% CI, 68.8%-93.5%) in the open group (p = 0.60). The rate of death or recurrence within five years of treatment was comparable between open and endoscopic (32.5% vs 15.0%, p = 0.26). Amongst Kadish C patients treated in the endoscopic era (after 2006), five-year survival was 76.2% (95% CI, 52.1%-100.0%) in the endoscopic cohort and 64.8% (95% CI, 39.3%-100.0%) in the open group (p = 0.70).
CONCLUSIONS: The surgical approach for ENB resection is dictated by tumor extension. Endoscopic resection offers a less invasive approach with comparable post-operative outcomes in appropriately selected patients.
