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Management of orbital invasion in esthesioneuroblastoma: 14 years’ experience

BACKGROUND: There is a scarcity of data about the prognostic value of orbital invasion in esthesioneuroblastoma (ENB), as well as about its management strategies. Indications for the preservation of orbital contents remain controversial, and the evaluation of orbital invasion has been ill defined. M...

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Autores principales: Li, Ruichen, Tian, Shu, Zhu, Yi, Yan, Li, Zhu, Wenjia, Quan, Huatao, Wang, Shengzi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567903/
https://www.ncbi.nlm.nih.gov/pubmed/31196122
http://dx.doi.org/10.1186/s13014-019-1313-1
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author Li, Ruichen
Tian, Shu
Zhu, Yi
Yan, Li
Zhu, Wenjia
Quan, Huatao
Wang, Shengzi
author_facet Li, Ruichen
Tian, Shu
Zhu, Yi
Yan, Li
Zhu, Wenjia
Quan, Huatao
Wang, Shengzi
author_sort Li, Ruichen
collection PubMed
description BACKGROUND: There is a scarcity of data about the prognostic value of orbital invasion in esthesioneuroblastoma (ENB), as well as about its management strategies. Indications for the preservation of orbital contents remain controversial, and the evaluation of orbital invasion has been ill defined. METHODS: This retrospective analysis contained 60 ENB patients with orbital invasion who underwent radiotherapy with or without surgery over the past 14 years. Orbital invasion was classified into three grades. RESULTS: There were 52 patients at stage C and 8 at stage D, according to Foote classifications. Grade I, grade II and grade III orbital invasion was detected in 12, 23, and 25 patients, respectively. The median follow-up was 57 months (IQR 32–95 months). Fourteen patients received radical radiotherapy, with a 5-year overall survival (OS) of 63.5%; 46 received surgery plus radiation, with a 5-year OS of 70.7%; and the difference was not statistically significant (p = 0.847). Orbital preservation was feasible in 100% of cases, including 18 cases that extended to extraocular muscles or the eye globe. Five-year locoregional relapse-free survival was 100% in patients with prophylactic elective neck irradiation (PENI) and 58.1% in patients without PENI (p = 0.004). Univariate analysis showed that grade II/III orbital invasion was associated with poorer OS and progression-free survival. Neck metastasis (with a Foote stage of D) was independently associated with shorter OS and distant metastasis–free survival in multivariate analysis. CONCLUSIONS: Our data suggested that primary radiotherapy achieved comparable survival to surgery plus radiotherapy in advanced ENB. Invasion of either the extraocular muscles or the eye globe is not a contraindication for eye-sparing surgery. Orbital invasion in grade II/III was significantly associated with adverse survival outcomes. Prophylactic radiotherapy to the neck with N0 significantly reduces the risk of regional recurrence.
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spelling pubmed-65679032019-06-27 Management of orbital invasion in esthesioneuroblastoma: 14 years’ experience Li, Ruichen Tian, Shu Zhu, Yi Yan, Li Zhu, Wenjia Quan, Huatao Wang, Shengzi Radiat Oncol Research BACKGROUND: There is a scarcity of data about the prognostic value of orbital invasion in esthesioneuroblastoma (ENB), as well as about its management strategies. Indications for the preservation of orbital contents remain controversial, and the evaluation of orbital invasion has been ill defined. METHODS: This retrospective analysis contained 60 ENB patients with orbital invasion who underwent radiotherapy with or without surgery over the past 14 years. Orbital invasion was classified into three grades. RESULTS: There were 52 patients at stage C and 8 at stage D, according to Foote classifications. Grade I, grade II and grade III orbital invasion was detected in 12, 23, and 25 patients, respectively. The median follow-up was 57 months (IQR 32–95 months). Fourteen patients received radical radiotherapy, with a 5-year overall survival (OS) of 63.5%; 46 received surgery plus radiation, with a 5-year OS of 70.7%; and the difference was not statistically significant (p = 0.847). Orbital preservation was feasible in 100% of cases, including 18 cases that extended to extraocular muscles or the eye globe. Five-year locoregional relapse-free survival was 100% in patients with prophylactic elective neck irradiation (PENI) and 58.1% in patients without PENI (p = 0.004). Univariate analysis showed that grade II/III orbital invasion was associated with poorer OS and progression-free survival. Neck metastasis (with a Foote stage of D) was independently associated with shorter OS and distant metastasis–free survival in multivariate analysis. CONCLUSIONS: Our data suggested that primary radiotherapy achieved comparable survival to surgery plus radiotherapy in advanced ENB. Invasion of either the extraocular muscles or the eye globe is not a contraindication for eye-sparing surgery. Orbital invasion in grade II/III was significantly associated with adverse survival outcomes. Prophylactic radiotherapy to the neck with N0 significantly reduces the risk of regional recurrence. BioMed Central 2019-06-13 /pmc/articles/PMC6567903/ /pubmed/31196122 http://dx.doi.org/10.1186/s13014-019-1313-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Li, Ruichen
Tian, Shu
Zhu, Yi
Yan, Li
Zhu, Wenjia
Quan, Huatao
Wang, Shengzi
Management of orbital invasion in esthesioneuroblastoma: 14 years’ experience
title Management of orbital invasion in esthesioneuroblastoma: 14 years’ experience
title_full Management of orbital invasion in esthesioneuroblastoma: 14 years’ experience
title_fullStr Management of orbital invasion in esthesioneuroblastoma: 14 years’ experience
title_full_unstemmed Management of orbital invasion in esthesioneuroblastoma: 14 years’ experience
title_short Management of orbital invasion in esthesioneuroblastoma: 14 years’ experience
title_sort management of orbital invasion in esthesioneuroblastoma: 14 years’ experience
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567903/
https://www.ncbi.nlm.nih.gov/pubmed/31196122
http://dx.doi.org/10.1186/s13014-019-1313-1
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