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Clin Otolaryngol. 2018 Dec;43(6):1566-1572. doi: 10.1111/coa.13216. Epub 2018 Sep 26.

Surgery, radiotherapy or a combined modality for jugulotympanic paraganglioma of Fisch class C and D.

Author information

1
Department of otolaryngology and Head & Neck surgery, Radboudumc, Nijmegen, The Netherlands.
2
Department of Radiation Oncology, Radboudumc, Nijmegen, The Netherlands.
3
Department of Neurosurgery, St. Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
4
Department of Endocrinology, Radboudumc, Nijmegen, The Netherlands.
5
Department of otology and Head & Neck Surgery, MUMC+Maastricht, the Netherlands.

Abstract

OBJECTIVES:

To identify the risks associated with surgery, radiotherapy or a combined treatment approach for Fisch class C and D jugulotympanic paraganglioma, in order to develop an individualised approach for each patient depending on Fisch class, age, mutation presence, tumour size growth rate and presenting symptoms.

DESIGN:

A retrospective multicenter cohort study with all patient records of patients with a head and neck paraganglioma in the Radboudumc, Nijmegen and the St. Elisabeth Hospital, Tilburg, the Netherlands.

MAIN OUTCOME MEASURES:

Local control, cranial nerve damage, complications, function recovery.

RESULTS:

We found highest local control rates after tumour debulking with postoperative radiotherapy in case of residual tumour growth, referred to as the combined treatment group, (100%; n = 19), which was significantly higher than the surgical group (82%; n = 17; P = 0.00), but did not differ from the radiotherapy group (90%; n = 29). There were significantly less complications in the radiotherapy group, when compared to surgery (63 vs 27%; P = 0.002) and the combined group (44 vs 27%; P = 0.016). Furthermore,: using a logistic regression model, we found that pretreatment tumour growth was a negative predictor for post-treatment cranial nerve function recovery (OR = 50.178, P = 0.001), reducing the chance of symptom recovery (67.3% vs 35.7%) post-treatment.

CONCLUSIONS:

Radiotherapy should be the treatment of choice for the elderly. For younger patients, tumour debulking should be considered, with potential radiotherapy in case of residual tumour growth.

KEYWORDS:

debulking; jugulotympanic; paraganglioma; radiotherapy; surgery

PMID:
30160027
DOI:
10.1111/coa.13216
[Indexed for MEDLINE]

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