Abstract：
OBJECTIVE: Esthesioneuroblastoma (ENB) is a rare malignancy of the sinonasal tract and its infrequency has confounded efforts at clearly describing the survival trends associated with this neoplasm over the years. In this study, we reviewed survival trends in ENB and investigated the impact of treatment extent and modality on patient outcomes.
METHODS: We accessed the Surveillance, Epidemiology, and End Result (SEER) program to identify ENB cases from 1998 to 2016. A χ2 test was used to compare the categorical covariates and a t test or Mann-Whitney U test was utilized for continuous variables. The impact of prognostic factors on survival was computed using a Kaplan-Meier analysis and multivariate Cox proportional hazards model. We divided ENB patients into 4 periods including 1998-2002, 2003-2007, 2008-2012, and 2013-2016, and investigated survival trends using the Kaplan-Meier curve and log-rank test.
RESULTS: ENB patients who underwent biopsy alone were associated with older age, larger tumor diameter, increased rates of tumor extension, nodal/distant metastases, and advanced stages as compared with patients undergoing tumor resection. Our results also demonstrated that surgical resection and adjuvant radiotherapy could confer survival advantages, whereas chemotherapy was associated with reduced survival in patients with ENB. Over the past 2 decades, surprisingly, there has been no change in survival rates for patient with ENB (P = 0.793).
CONCLUSIONS: Despite advanced diagnostic studies and modernized treatment approaches, ENB survival has remained unchanged over the years, calling for improved efforts to develop appropriate individualized interventions for this rare tumor entity. Our results also confirmed that surgery and adjuvant radiotherapy is associated with improved patient survival whereas the use of chemotherapy should be considered carefully.
METHODS: We accessed the Surveillance, Epidemiology, and End Result (SEER) program to identify ENB cases from 1998 to 2016. A χ2 test was used to compare the categorical covariates and a t test or Mann-Whitney U test was utilized for continuous variables. The impact of prognostic factors on survival was computed using a Kaplan-Meier analysis and multivariate Cox proportional hazards model. We divided ENB patients into 4 periods including 1998-2002, 2003-2007, 2008-2012, and 2013-2016, and investigated survival trends using the Kaplan-Meier curve and log-rank test.
RESULTS: ENB patients who underwent biopsy alone were associated with older age, larger tumor diameter, increased rates of tumor extension, nodal/distant metastases, and advanced stages as compared with patients undergoing tumor resection. Our results also demonstrated that surgical resection and adjuvant radiotherapy could confer survival advantages, whereas chemotherapy was associated with reduced survival in patients with ENB. Over the past 2 decades, surprisingly, there has been no change in survival rates for patient with ENB (P = 0.793).
CONCLUSIONS: Despite advanced diagnostic studies and modernized treatment approaches, ENB survival has remained unchanged over the years, calling for improved efforts to develop appropriate individualized interventions for this rare tumor entity. Our results also confirmed that surgery and adjuvant radiotherapy is associated with improved patient survival whereas the use of chemotherapy should be considered carefully.
摘要：
目的：鼻腔神经母细胞瘤（ENB）是一种罕见的鼻腔鼻道恶性肿瘤，多年来，它的不常见使人们难以清楚地描述与该肿瘤相关的生存趋势。在这项研究中,我们回顾了ENB的生存趋势,并研究了治疗范围和方式对患者结局的影响.
方法：我们访问了监控，流行病学,和最终结果（SEER）计划，以识别1998年至2016年的ENB病例。使用χ2检验比较分类协变量，并对连续变量使用t检验或Mann-WhitneyU检验。使用Kaplan-Meier分析和多变量Cox比例风险模型计算预后因素对生存的影响。我们将ENB患者分为4个时期，包括1998-2002年，2003-2007年，2008-2012年和2013-2016年，并使用Kaplan-Meier曲线和对数秩检验调查生存趋势。
结果：仅接受活检的ENB患者与年龄较大有关，肿瘤直径较大，肿瘤扩展率增加，淋巴结/远处转移，和晚期相比，接受肿瘤切除术的患者。我们的结果还表明，手术切除和辅助放疗可以赋予生存优势，而化疗与ENB患者生存率降低相关。在过去的20年里,令人惊讶的是,ENB患者的生存率没有变化(P=0.793).
结论：尽管有先进的诊断研究和现代化的治疗方法，ENB生存多年来一直保持不变，呼吁加强努力，为这种罕见的肿瘤实体制定适当的个性化干预措施。我们的结果还证实，手术和辅助放疗与改善患者生存率有关，而化疗的使用应仔细考虑。
方法：我们访问了监控，流行病学,和最终结果（SEER）计划，以识别1998年至2016年的ENB病例。使用χ2检验比较分类协变量，并对连续变量使用t检验或Mann-WhitneyU检验。使用Kaplan-Meier分析和多变量Cox比例风险模型计算预后因素对生存的影响。我们将ENB患者分为4个时期，包括1998-2002年，2003-2007年，2008-2012年和2013-2016年，并使用Kaplan-Meier曲线和对数秩检验调查生存趋势。
结果：仅接受活检的ENB患者与年龄较大有关，肿瘤直径较大，肿瘤扩展率增加，淋巴结/远处转移，和晚期相比，接受肿瘤切除术的患者。我们的结果还表明，手术切除和辅助放疗可以赋予生存优势，而化疗与ENB患者生存率降低相关。在过去的20年里,令人惊讶的是,ENB患者的生存率没有变化(P=0.793).
结论：尽管有先进的诊断研究和现代化的治疗方法，ENB生存多年来一直保持不变，呼吁加强努力，为这种罕见的肿瘤实体制定适当的个性化干预措施。我们的结果还证实，手术和辅助放疗与改善患者生存率有关，而化疗的使用应仔细考虑。
