Transnasal endoscopic surgery in selected nasal‐ethmoidal cancer with suspected brain invasion: Indications, technique, and outcomes

Transnasal endoscopic surgery in selected nasal‐ethmoidal cancer with suspected brain invasion: Indications, technique, and outcomes

Background In nasal‐ethmoidal malignancies, brain involvement is associated with dismal prognosis. Method Patients undergoing endoscopic resection with transnasal craniectomy and subpial dissection (ERTC‐SD) for brain‐invading nasal‐ethmoidal cancer between 2008 and 2016 were included. Complications...

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Bibliographic Details
Published in:Head & neck Vol. 41; no. 6; pp. 1854 - 1862
Main Authors: Mattavelli, Davide, Ferrari, Marco, Bolzoni Villaret, Andrea, Schreiber, Alberto, Rampinelli, Vittorio, Turri‐Zanoni, Mario, Lancini, Davide, Taglietti, Valentina, Accorona, Remo, Doglietto, Francesco, Battaglia, Paolo, Castelnuovo, Paolo, Nicolai, Piero
Format: Journal Article
Language:English
Published: Hoboken, USA John Wiley & Sons, Inc 01-06-2019
Wiley Subscription Services, Inc
Subjects:
brain
Brain tumors
Carcinoma
Edema
Endoscopy
ethmoid sinus
Head and neck
Intestine
Medical prognosis
Morbidity
nasal cavity
neoplasms
Neuroendocrine tumors
Surgery
endoscopy
ethmoid sinus
brain
neoplasms
nasal cavity
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Summary:Background In nasal‐ethmoidal malignancies, brain involvement is associated with dismal prognosis. Method Patients undergoing endoscopic resection with transnasal craniectomy and subpial dissection (ERTC‐SD) for brain‐invading nasal‐ethmoidal cancer between 2008 and 2016 were included. Complications were analyzed in all patients, whereas oncological outcomes only in patients with pathological brain invasion. The prognostic impact of previous treatments, brain edema, and histology was assessed. Hospitalization ratio was calculated. Results Nineteen patients received ERTC‐SD and 11 had pathological‐proven brain invasion. Histologies were 6 olfactory neuroblastomas (ONB), 3 neuroendocrine carcinomas, and 2 intestinal‐type adenocarcinomas. Mean follow‐up was 21.9 months. Three‐year overall, local recurrence‐free, and distance recurrence‐free survivals were 65.5%, 81.8%, and 68.2%, respectively. Overall and distant recurrence‐free survivals were significantly better in patients with ONB (P = 0.032 and P = 0.013, respectively). Hospitalization ratio was 4.1%. Complication rate was 10.5%. Conclusion In selected nasal‐ethmoidal tumors with brain invasion, ERTC‐SD can provide good local control, satisfactory survival, and limited morbidity.
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ISSN:1043-3074
1097-0347
DOI:10.1002/hed.25621