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首页> 外文期刊>The Annals of otology, rhinology, and laryngology >Comparison of Open and Endoscopic Approaches in the Resection of Esthesioneuroblastoma
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Comparison of Open and Endoscopic Approaches in the Resection of Esthesioneuroblastoma

机译：Esthesioneuroblastoma切除术中的开放和内窥镜方法的比较

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Background: Olfactory neuroblastoma, or esthesioneuroblastoma (ENB), is an uncommon sinonasal malignancy arising from olfactory neuroepithelium that is optimally treated with surgical resection. The objective of this study is to determine preoperative predictors of undergoing open versus endoscopic approach for ENB and to investigate significant postoperative survival outcomes between the two surgical approaches. Methods: The National Cancer Database (NCDB) was queried for cases of ENB histology that were treated surgically from 2010 to 2015. Groups were stratified into open or endoscopic approach cohorts. Patient demographics, tumor characteristics, treatment modality, and 5-year overall survival were compared between the two groups using Chi-Square analysis and Kaplan-Meier survival analysis. Cases were classified as Kadish stage A, B, C, or D based on the "Collaborative Stage-Extension" codes in NCDB. Results: Of 533 patients meeting inclusion criteria, 276 (51.8%) patients underwent open, and 257 (48.2%) patients underwent endoscopic surgical approaches. Patients undergoing endoscopic surgery were more likely to be Kadish stages A and B and less likely to be stages C and D (P = .020). Those undergoing endoscopic approach overall had a shorter mean hospital stay postoperatively (3.8 vs. 7.0 days,P < .001). Endoscopic cases had a greater 5-year overall survival (81.9% vs. 75.6%,P = .030); after multivariate regression, there was a trend toward survival benefit to endoscopic surgery that did not reach clinical significance (HR 0.644, [0.392-1.058],P = .083). Conclusion: Although not statistically significant, there is a trend toward increased overall survival with an endoscopic approach in patients undergoing surgery for ENB as compared to an open approach, regardless of Kadish stage. An endoscopic approach is an adequate alternative to an open approach for the surgical treatment of ENB.
机译：背景：嗅神经母细胞瘤，或称嗅神经母细胞瘤（ENB），是一种罕见的鼻腔恶性肿瘤，起源于嗅神经上皮，手术切除是最佳治疗方法。本研究的目的是确定接受开放式和内镜手术治疗ENB的术前预测因素，并研究两种手术方法的术后生存率。方法：查询国家癌症数据库（NCDB）中2010年至2015年手术治疗的ENB组织学病例。各组被分为开放组和内窥镜组。采用卡方分析和Kaplan-Meier生存分析比较两组患者的人口统计学、肿瘤特征、治疗方式和5年总生存率。根据NCDB中的“协作阶段扩展”代码，将病例分为卡迪什A、B、C或D期。结果：在533例符合纳入标准的患者中，276例（51.8%）患者接受了开放手术，257例（48.2%）患者接受了内镜手术。接受内窥镜手术的患者更有可能处于Kadish A期和B期，而不太可能处于C期和D期（P=0.020）。接受内镜手术的患者术后平均住院时间较短（分别为3.8天和7.0天，P<0.001）。内镜下病例的5年总生存率更高（81.9%对75.6%，P=0.030）；在多变量回归后，内镜手术的存活率有上升趋势，但未达到临床意义（HR0.644，[0.392-1.058]，P=0.083）。结论：尽管没有统计学意义，但与开放手术相比，无论Kadish分期，内镜手术治疗ENB患者的总生存率有增加的趋势。对于ENB的外科治疗，内窥镜入路是开放式入路的适当替代方法。

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