Time trends in recurrence of juvenile nasopharyngeal angiofibroma: Experience of the past 4 decades

Background: An analysis of time distribution of juvenile nasopharyngeal angiofibroma (JNA) from the last 4 decades is presented. Methods: Sixty recurrences were analyzed as per actuarial survival. SPSS software was used to generate Kaplan-Meier (KM) curves and time distributions were compared by Log-rank, Breslow and Tarone-Ware test. Results: The overall recurrence rate was 17.59%. Majority underwent open transpalatal approach(es) without embolization. The probability of detecting a recurrence was 95% in first 24 months and comparison of KM curves of 4 different time periods was not significant. Conclusion: This is the first and largest series to address the time-distribution. The required follow up period is 2 years. Our recurrence is just half of the largest series (reported so far) suggesting the superiority of transpalatal techniques. The similarity of curves suggests less likelihood for recent technical advances to influence the recurrence that as per our hypothesis is more likely to reflect tumor biology per se. (c) 2016 Elsevier Inc. All rights reserved.