Compartmentalized endoscopic resection of the olfactory cleft for nasal intestinal adenocarcinomas. Issue 11 (26th June 2018)

• Record Type: Journal Article
• Authors: Russel, Adrien; Nguyen, Duc Trung; Vigouroux, Charlène; Gallet, Patrice; Vignaud, Jean‐Michel; Rumeau, Cécile; Jankowski, Roger
• Is Part Of: Head & neck. Volume 40:Issue 11(2018)
• Page Start: 2389
• Page End: 2398
• Publication Date: 2018-06-26
• Subjects: endoscopic surgery -- ethmoid bone -- nasal intestinal adenocarcinoma -- olfactory cleft -- sinonasal tumor; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.25349
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: The purpose of this study was to describe the pathology of the different compartments in endoscopic resection of nasal intestinal‐type adenocarcinomas (ITACs) and its relationships with oncologic outcomes. Methods: This retrospective study included all patients endoscopically operated for nasal ITACs, followed by radiotherapy in the majority of cases, between 2004 and 2014. The surgery systematically separated 3 compartments: ethmoid lateral mass, olfactory cleft, and anterior cranial fossa (in cases with skull‐base invasion) to analyze their pathological "focal" or "massive" invasion by the tumor. Results: Sixty‐seven patients (aged 69.2 ± 9.8 years) were included. Twenty‐nine patients (43.3%) had only pathological focal invasion. At 61.0 ± 41.7 months of mean follow‐up, the recurrence rates were 34.2% in the group with massive invasion and 10.3% in the group with focal invasion ( P = .023). The disease‐specific death rate had a tendency to be higher in the group with massive invasion (23.7% vs 6.9% for the group with focal invasion; P = .097). By Kaplan‐Meier analysis, the 5‐year disease‐specific survival rate was better in the group with focal invasion than the group with massive invasion ( P = .01). The 5‐year overall survival was not different between the 2 groups (47.4% and 65.5% for focal invasion and massive invasion respectively; P = .14). Conclusion: Compartmentalized endoscopic resection, combined with postoperative radiotherapy, is one way to operate on nasal ITACs with good oncologic outcomes.