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| |  Endoscopic Surgery Effective as Open Surgery for Nasal Cancer BOSTON -- July 7, 2009 -- Researchers have shown that endoscopic surgery is a valid treatment option for treating the rare nasal cavity cancer esthesioneuroblastoma, in addition to traditional open surgery and nonsurgical treatments. These findings appear in the July issue of Laryngoscope. Esthesioneuroblastoma, which develops in the upper part of the nasal cavity, is thought to derive from neural tissue associated with the sense of smell. While this tumour generally grows slowly, in some cases it progresses rapidly and aggressively. The faster growing tumours are capable of widespread metastasis. According to researchers from Boston University School of Medicine (BUSM), Boston, Massachusetts, the complex nature of esthesioneuroblastoma has led to much debate regarding the optimal treatment modality. Several previous studies have analysed survival rates of various treatments, the majority of which have shown that the most effective strategy is a combination of surgery and radiotherapy with or without chemotherapy. However, the evolution of surgical techniques has created another surgical option in the form of endoscopic surgery. This study examined recent literature regarding outcomes of esthesioneuroblastoma treatment between 1992 and 2008 and found overall, surgery yielded more disease-free outcomes and better survival rates than nonsurgical treatment modalities. Endoscopic surgery produced better survival rates than open surgery. In addition, there was no significant difference between follow-up times in the endoscopic and open surgery groups. “We did find a statistically significant difference between the study publication years of the open and endoscopic surgery groups because the open surgery literature considerably predated endoscopic treatment. To account for this discrepancy, we grouped the data according to publication year and performed further analysis and found the endoscopic surgery group maintained better survival rates than the open surgery group,” said lead author Anand K. Devaiah, MD, FACS, Departments of Otolaryngology - Head and Neck Surgery and Neurological Surgery, Boston Medical Center, Boston, Massachusetts. He and his co-author, Michael Andreoli, BUSM III student, presented their work at the Triological Society Eastern Section Meeting in Boston earlier this year. “Although this meta-analysis suggests that the efficacy of endoscopic and endoscopic- assisted surgery is comparable to open surgery for less invasive tumours, further prospective studies are required to establish more definite conclusions, especially for larger tumours,” added Dr. Devaiah. SOURCE: Boston University Medical Center
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