Spread patterns of lymph nodes and the value of elective neck irradiation for esthesioneuroblastoma.
OBJECTIVES
This study was aimed to characterize patterns of lymphatic spread and assess the value of prophylactic elective neck irradiation (ENI) for esthesioneuroblastoma (ENB).


METHODS
A retrospectively analysis of 116 patients with newly diagnosed ENB at our institution over 35-year period was undertaken.


RESULTS
32 patients (28%) presented lymph node metastasis at initial diagnosis, the common sites involved were level II, Ib, level III and VIIa. Among 80 N-negative patients staged in Modified Kadish B/C, 50 patients were delivered with ENI, 30 patients were not. The 5-year regional failure-free survival was 98% in patients treated with ENI and 75% in patients without ENI (p=0.005), regional failure rate decreased significantly from 23% (7/30) to 2% (1/50) after ENI (p=0.002). Multivariate analysis also suggested that ENI was an independent favorable predictor for regional controlling (HR, 0.102; 95% CI: 0.012-0.848; p=0.035).


CONCLUSIONS
This is the largest cohort of ENB so far in a single institute, and also the first detailed description of nodal spread patterns of N-positive ENB. Elective neck irradiation reduced the regional failure significantly and should be recommended as a part of initial treatment strategy for patients staged with Modified Kadish B/C.
['Yin|Zhen-zhen|ZZ|', 'Luo|Jing-wei|JW|', 'Gao|Li|L|', 'Yi|Jun-lin|JL|', 'Huang|Xiao-dong|XD|', 'Qu|Yuan|Y|', 'Wang|Kai|K|', 'Zhang|Shi-ping|SP|', 'Xiao|Jian-ping|JP|', 'Xu|Guo-zhen|GZ|', 'Li|Ye-xiong|YX|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D002648:Child D015331:Cohort Studies D018304:Esthesioneuroblastoma, Olfactory D005260:Female D006801:Humans D008198:Lymph Nodes D008207:Lymphatic Metastasis D008297:Male D008875:Middle Aged D009296:Nasal Cavity D009669:Nose Neoplasms D012189:Retrospective Studies D055815:Young Adult
Elective neck irradiation Esthesioneuroblastoma Failure pattern Node metastases Regional spread pattern