Esthesioneuroblastoma - What is the optimal treatment?

A retrospective review was conducted on 13 patients with esthesioneuroblast oma (ENB), treated at our institution from 1977 to 1997. According to the K adish classification, one patient was in stage A, 5 patients were classifie d as stage B and 7 patients were in stage C. Five-year disease-specific sur vival was found to be 51%. Forty-six percent of the patients experienced re lapse and despite intensive salvage therapy, median survival after recurren ces was only 12 months. This indicates the need for good primary control in local as well as distant disease. The role of pre- versus postoperative ra diotherapy to secure good local control is discussed and compared with the literature, and treatment guidelines are proposed. The rumours were graded according to the Hyams' classification and its importance as a prognostic f actor is briefly discussed.