Current Management of Head and Neck Paragangliomas: A Multicenter Series With Long-Term Follow-Up

被引:0
作者
Lamas, Cristina [1 ,2 ]
Febrero, Beatriz [3 ,4 ]
Casteras, Anna [5 ]
Romero-Lluch, Ana [6 ]
Recio-Cordova, Jose Maria [7 ]
Ros, Inmaculada [8 ]
Iglesias, Pedro [9 ]
Hanzu, Felicia A. [10 ]
Araujo-Castro, Marta [11 ]
Guerrero-Perez, Fernando [12 ]
Ares, Jessica [13 ,14 ]
Menendez, Edelmiro [14 ]
Paja, Miguel [15 ]
alvarez-Escola, Cristina
Librizzi, Soledad [16 ]
Sanchez-Sobrino, Paula [17 ]
Andres-Pretel, Fernando [18 ,19 ,20 ]
Calatayud, Maria [16 ]
机构
[1] Complejo Hosp Univ Albacete, Endocrinol Dept, C Hermanos Falco,37, Albacete 02006, Spain
[2] Univ Castilla La Mancha, Fac Med, Albacete, Spain
[3] Hosp Univ Virgen de la Arrixaca, Endocrine Surg, Gen Surg Dept, Murcia, Spain
[4] Univ Murcia, Fac Med, Murcia, Spain
[5] Hosp Univ Vall Dhebron, Microbiol Dept, Barcelona, Spain
[6] Hosp Univ Virgen del Rocio, Serv Inmunol, Seville, Spain
[7] Hosp Univ Salamanca, Endocrinol Dept, Salamanca, Spain
[8] Univ Hosp Virgen de la Arrixaca, Endocrinol Dept, Murcia, Spain
[9] Hosp Univ Puerta de Hierro Majadahonda, Dept Endocrinol & Nutr, Madrid, Spain
[10] Hosp Clin Barcelona, Endocrinol Dept, Barcelona, Spain
[11] Hosp Univ Ramon y Cajal, Endocrinol Dept, Madrid, Spain
[12] Hosp Univ Bellvitge, Endocrinol Dept, Barcelona, Spain
[13] Hlth Res Inst Principal Asturias ISPA, Endocrinol Nutr Diabet & Obes Grp, Oviedo, Spain
[14] Hosp Univ Cent Asturias, Endocrinol Dept, Oviedo, Spain
[15] Univ Basque Country, UPV EHU, Hosp Univ Basurto, Endocrinol Dept,OSI Bilbao Basurto, Bilbao, Spain
[16] Hosp Univ 12 Octubre, Endocrinol Dept, Madrid, Spain
[17] Complejo Hosp Univ Pontevedra, Endocrinol Dept, Pontevedra, Spain
[18] Fdn Hosp Nacl Paraplejicos de Toledo, Toledo, Spain
[19] Univ Castilla la Mancha, Dept Math, Ciudad Real, Spain
[20] Complejo Hosp Univ Albacete, Clin Res Support Unit, Albacete, Spain
关键词
active surveillance; head and neck; paraganglioma; succinate dehydrogenase; WAIT-AND-SCAN; NATURAL-HISTORY; RADIOTHERAPY; EFFICACY; THERAPY;
D O I
暂无
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objective, Study Design, Setting, MethodsTo improve our knowledge about head and neck paragangliomas (HN-PGL), the clinical characteristics of all the patients with HN-PGL included in the Spanish Registry were analyzed, as well as the treatment modalities and their outcomes.ResultsA total of 202 patients, 67.8% women, aged 53.1 +/- 17.4, with 264 HN-PGL, from 16 Spanish hospitals, were included. Tumors were located in the carotid body in 61%, jugular bulb in 20.5%, tympanic area in 10.2%, and along the vagal nerve in 6.4%. Multiple tumors developed in 20.8% and metastatic disease in 4%. A genetic study was done in 64.4% and showed a pathogenic variant in SDHx in 50%. These patients were younger, with no sex predominance, and had more multiple and metastatic tumors. Tumors were treated by surgery in 134 patients, radiotherapy in 33, and other treatments in 20, and were observed without active treatment in 41 patients, who were older, more often asymptomatic, and had smaller tumors. Tumors treated with radiotherapy were larger and more often in locations other than the carotid body. After a median follow-up of 80 months (interquartile range: 41-136), 6.9% had died; among the survivors, 48.4% were disease-free, 42.1% stable, and 9.4% had progressed. The rate of sequelae was similar among patients submitted to surgery, radiotherapy, or observation. We could not identify any prognostic factor for progression.ConclusionMost HN-PGL are localized slow-growing tumors. Long-term survival is high, even in case of metastasis. Although surgery is the most common treatment, radiotherapy and active surveillance are safe approaches.
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页码:176 / 183
页数:8
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