[Clinical analysis of 34 cases of esthesioneuroblastoma].

Objective: To study the diagnosis, treatment policy and prognosis in patients with esthesioneuroblastoma.
Methods: A retrospective review was conducted in 34 patients treated at Cancer Hospital of CAMS from 1958 to 1998. According to the Kadish system, the patients were staged as follows: stage A, 1 case; stage B, 9 cases; and stage C, 24 cases. Three patients were treated with surgery alone, 9 irradiation alone, and 15 combination with surgery and radiation, 4 combination with radiation and chemotherapy and 3 surgery, radiation and chemotherapy.
Results: The overall 5-year survival rate was 47.1% (16/34). The survival rates for stag A, B, and C were 100% (1/1), 88.9% (8/9), and 29.2% (7/24) respectively. The survival rates for surgery alone, radiation alone and combined therapy were 33.3% (1/3), 33.3% (3/9), and 54.5% (7/24), respectively. The local control rate and distant metastasis rate were 61.8% (21/34) and 32.4% (11/34), respectively. There were 10 patients died of distant metastasis and 5 patients died of local recurrence. The survival rate in patients with early stage (A + B) esthesioneuroblastoma was significantly better than that in patients with advanced stage (C) (chi2 = 8. 174, P = 0.004). The young patients (< or = 30 years) had a remarkable higher distant metastasis rate (chi2 = 3.865, P = 0.049) and poor prognosis (chi2 = 4.194, P = 0.041) than elder patients.
Conclusions: Early detection and combined therapy were important to improve survival rate. The combined therapy with preoperative radiation therapy and surgery could help to achieve excellent local control. Distant metastasis was an important factor which affected the prognosis of the patients.