Abstract:
Objective:To investigate the clinical characteristics of esthesioneuroblastoma and the efficacy of endonasal endoscopic surgery combined with radiotherapy/chemotherapy. Methods:The clinical and surgical data of 17 patients with esthesioneuroblastoma who underwent endonasal endoscopic surgery in our department from September 2009 to June 2023 were retrospectively analyzed. Results:Among all patients, the modified Kadish stage B was identified in 4 patients, C in 10 patients, and D in 3 patients. Ten of them underwent endonasal endoscopic surgery without neck dissection in one day, whose average operation time is (5.2±2.5) hours and average blood loss is (192±162)mL. Skull base reconstructions were performed in 15 patients, postoperative complications were observed in 3 patients, and negative margins were obtained in 13 patients. All 17 patients were followed up for an average of (49.7±40.2) months. Three patients died and 6 had recurrence and/or metastasis. The 1-year, 2-year and 5-year overall survival rates were 88.2%, 80.2%, and 80.2%, respectively, and the 1-year, 2-year and 5-year disease-free survival rates were 82.4%, 82.4%, and 50.8%, respectively. The 2-year overall survival rates of patients with negative and positive margins were 100% and 25%, respectively, while the 2-year disease-free survival rates were 61.5% and 25.0%, respectively. Conclusion:Endonasal endoscopic surgery combined with radiotherapy/chemotherapy can achieve satisfactory effect in esthesioneuroblastoma, and the prognosis of patients with positive margins is poor.
目的:探讨嗅神经母细胞瘤的临床特点和经鼻内镜手术联合放/化疗的治疗效果。 方法:回顾性分析2009年9月—2023年6月我院收治的接受经鼻内镜手术治疗的17例嗅神经母细胞瘤患者的临床、手术资料及随访结果。 结果:17例患者中改良Kadish B期4例,C期10例,D期3例。10例患者一期行鼻内镜手术切除肿瘤(除外颈清),平均手术时长(5.2±2.5) h,平均出血量为(192.0±162.0) mL。15例患者行颅底重建,3例患者出现术后并发症,13例患者达到阴性切缘。所有患者均得以随访,平均随访(49.7±40.2)个月,死亡3例,复发和(或)转移6例。1、2和5年总体生存率分别为88.2%、80.2%和80.2%,1、2和5年无病生存率分别为82.4%、82.4%和50.8%。切缘阴性和切缘阳性的患者2年总体生存率分别为100.0%和25.0%,2年无病生存率分别为61.5%和25.0%。 结论:经鼻内镜手术联合放/化疗治疗嗅神经母细胞瘤疗效可靠,切缘阳性患者预后较差。.