Importance of neoadjuvant chemotherapy in olfactory neuroblastoma treatment: Series report and literature review

array:23 ["pii" => "S2173573518300553" "issn" => "21735735" "doi" => "10.1016/j.otoeng.2017.07.003" "estado" => "S300" "fechaPublicacion" => "2018-07-01" "aid" => "826" "copyright" => "Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Acta Otorrinolaringol Esp. 2018;69:208-13" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 164 "formatos" => array:3 [ "EPUB" => 42 "HTML" => 89 "PDF" => 33 ] ] "itemSiguiente" => array:19 [ "pii" => "S2173573518300498" "issn" => "21735735" "doi" => "10.1016/j.otoeng.2017.08.010" "estado" => "S300" "fechaPublicacion" => "2018-07-01" "aid" => "831" "copyright" => "Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Acta Otorrinolaringol Esp. 2018;69:214-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 231 "formatos" => array:3 [ "EPUB" => 82 "HTML" => 100 "PDF" => 49 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Analysis of Audiometric Relapse-Free Survival in Patients With Immune-Mediated Hearing Loss Exclusively Treated With Corticosteroids" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "214" "paginaFinal" => "218" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Análisis de supervivencia libre de recaída audiométrica en pacientes con hipoacusia inmunomediada tratados exclusivamente con corticoides" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1180 "Ancho" => 1497 "Tamanyo" => 71116 ] ] "descripcion" => array:1 [ "en" => "Function of survival distribution of the relapse event (Kaplan Meier), limited by the confidence intervals. In the abscissa axis we observe the time in months and how, as the year advances, the majority of patients have relapses. We have put a circle around the 4 censured patients, free from relapse in the first year." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Nieves Mata-Castro, Raimon García-Chilleron, Javier Gavilanes-Plasencia, Rafael Ramírez-Camacho, Alfredo García-Fernández, José Ramón García-Berrocal" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Nieves" "apellidos" => "Mata-Castro" ] 1 => array:2 [ "nombre" => "Raimon" "apellidos" => "García-Chilleron" ] 2 => array:2 [ "nombre" => "Javier" "apellidos" => "Gavilanes-Plasencia" ] 3 => array:2 [ "nombre" => "Rafael" "apellidos" => "Ramírez-Camacho" ] 4 => array:2 [ "nombre" => "Alfredo" "apellidos" => "García-Fernández" ] 5 => array:2 [ "nombre" => "José Ramón" "apellidos" => "García-Berrocal" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001651917301747" "doi" => "10.1016/j.otorri.2017.08.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001651917301747?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573518300498?idApp=UINPBA00004N" "url" => "/21735735/0000006900000004/v1_201807220439/S2173573518300498/v1_201807220439/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173573518300346" "issn" => "21735735" "doi" => "10.1016/j.otoeng.2017.06.014" "estado" => "S300" "fechaPublicacion" => "2018-07-01" "aid" => "817" "copyright" => "Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Acta Otorrinolaringol Esp. 2018;69:201-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 349 "formatos" => array:3 [ "EPUB" => 25 "HTML" => 243 "PDF" => 81 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Efficacy of Particle Repositioning Manoeuvres in Benign Positional Paroxysmal Vertigo: A Revision of 176 Cases Treated in a Tertiary Care Centre" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "201" "paginaFinal" => "207" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Eficacia de las maniobras de reposicionamiento canalicular en el vértigo posicional paroxístico benigno: revisión de 176 casos tratados en un centro hospitalario de tercer nivel" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1328 "Ancho" => 1610 "Tamanyo" => 73738 ] ] "descripcion" => array:1 [ "en" => "Lempert (or “barbeque”) manoeuvre: the affected left ear (black). 1. In the first movement the patient is in a lateral decubitus position towards the affected side. 2. The body is then rotated 90° towards the right. 3. The body is then rotated 180° towards the right. 4. Lastly the body is rotated 270° towards the right, so that the patient is face down. 5. The next step is to turn the body 360° towards the right, with the patient being in the original position." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Claudio Carnevale, Diego J. Arancibia-Tagle, Elena Rizzo-Riera, Guillermo Til-Perez, Pedro L. Sarría-Echegaray, Julio J. Rama-Lopez, Santiago Quer-Canut, German Fermin-Gamero, Manuel D. Tomas-Barberan" "autores" => array:9 [ 0 => array:2 [ "nombre" => "Claudio" "apellidos" => "Carnevale" ] 1 => array:2 [ "nombre" => "Diego J." "apellidos" => "Arancibia-Tagle" ] 2 => array:2 [ "nombre" => "Elena" "apellidos" => "Rizzo-Riera" ] 3 => array:2 [ "nombre" => "Guillermo" "apellidos" => "Til-Perez" ] 4 => array:2 [ "nombre" => "Pedro L." "apellidos" => "Sarría-Echegaray" ] 5 => array:2 [ "nombre" => "Julio J." "apellidos" => "Rama-Lopez" ] 6 => array:2 [ "nombre" => "Santiago" "apellidos" => "Quer-Canut" ] 7 => array:2 [ "nombre" => "German" "apellidos" => "Fermin-Gamero" ] 8 => array:2 [ "nombre" => "Manuel D." "apellidos" => "Tomas-Barberan" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001651917301565" "doi" => "10.1016/j.otorri.2017.06.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001651917301565?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573518300346?idApp=UINPBA00004N" "url" => "/21735735/0000006900000004/v1_201807220439/S2173573518300346/v1_201807220439/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Importance of neoadjuvant chemotherapy in olfactory neuroblastoma treatment: Series report and literature review" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "208" "paginaFinal" => "213" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ricardo Bartel, Xavier Gonzalez-Compta, Enric Cisa, Francesc Cruellas, Alberto Torres, Aleix Rovira, Manel Manos" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Ricardo" "apellidos" => "Bartel" "email" => array:1 [ 0 => "pilobartel@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Xavier" "apellidos" => "Gonzalez-Compta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Enric" "apellidos" => "Cisa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Francesc" "apellidos" => "Cruellas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Alberto" "apellidos" => "Torres" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Aleix" "apellidos" => "Rovira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "Manel" "apellidos" => "Manos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "ORL-HNS Department, Hospital Universitari de Bellvitge, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Neurosurgery Department, Hospital Universitari de Bellvitge, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Importancia de la quimioterapia neoadyuvante en el tratamiento del neuroblastoma olfatorio: serie de casos y revisión de la literatura" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1111 "Ancho" => 1473 "Tamanyo" => 133958 ] ] "descripcion" => array:1 [ "en" => "Disease free survival." ] ] ] "textoCompleto" => "IntroductionONB, also known as Esthesioneuroblastoma is a rare entity of malignant neoplasm which is believed to be formed at the neuroepithelial cells of the olfactory tract. It constitutes less than 5% of all malignant tumors of the nasal fossa and paranasal sinuses.<a class="elsevierStyleCrossRef" href="#bib0195">1</a> Mean age of presentation oscillates between 40 and 70 years old and has no gender predisposition.<a class="elsevierStyleCrossRef" href="#bib0200">2</a> The most common clinical manifestation described is nasal obstruction secondary to the presence of a mass in the nasal cavity, but it can debut with episodes of epistaxis, rhinorrhea and/or facial pain or facial fullness. Clinical examination usually demonstrates a polypoid mass located in the cranial portion of the nasal cavity. Depending on the extension and location of the tumor, different symptomatology can be observed: anosmia if it affects the cribriform plate; if it has orbital extension, can produce ocular pain, diplopia or epiphora; otalgia or otitis media with effusion if it extends to the eustachian tube; cognitive/behavioral changes with headaches if it extends to the anterior cranial fossa.<a class="elsevierStyleCrossRefs" href="#bib0205">3–6</a> Paraneoplastic syndromes are rarely described.<a class="elsevierStyleCrossRef" href="#bib0225">7</a>The diagnostic procedure requires a positive biopsy and the most commonly used staging classification is the Kadish clinical system<a class="elsevierStyleCrossRef" href="#bib0230">8</a> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), TNM known as Dulguerov staging system has also been described (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Hyams histological grading system grades ONB in four groups, from I to IV depending on mitotic activity and necrosis, being I/II as low grade tumors and III/IV as high grade tumors.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia>ONB are slow-growing tumors with unspecific symptomatology leading to a delayed diagnosis. At the moment of diagnosis most of the cases correspond to Kadish B or C stages.<a class="elsevierStyleCrossRef" href="#bib0200">2</a> Imaging with MRI and CT scan are essential for staging and extension. While CT gives better information about bone invasion, MRI defines more accurately margins and adjacent soft tissue extension, such as the anterior cranial fossa and orbital tissues.<a class="elsevierStyleCrossRefs" href="#bib0235">9–11</a> PET/CT scan has importance in assessing extension in locally advanced Kadish C or Hyams III/IV cases, which have high risk of distant metastases.<a class="elsevierStyleCrossRefs" href="#bib0250">12,13</a> Imaging studies do not differentiate ONB from other naso-sinusal neoplasms.Differential diagnosis must include neuroendocrines carcinomas, sinonasal undifferentiated carcinoma, rhabdomyosarcoma, melanomas and metastases.To this day, due to the low frequency of this entity, treatment has not been established by randomized clinical trials and has been only assessed by retrospective observational studies.<a class="elsevierStyleCrossRef" href="#bib0260">14</a> Historically, management of the primary tumor has been surgery with or without adjuvant radiotherapy (ART) and in selective cases, also adjuvant chemotherapy (ACT).<a class="elsevierStyleCrossRef" href="#bib0265">15</a> It has been generally indicated in observational studies that overall survival (OS) and disease free survival (DFS) are increased when treated with surgery and RT compared to RT alone.<a class="elsevierStyleCrossRef" href="#bib0270">16</a>Related to surgical treatment, two different surgical approaches have been used. Endoscopic approach has the advantage of minimizing complications.<a class="elsevierStyleCrossRefs" href="#bib0275">17–20</a> Surgical management of ONB is continuously evolving, with contemporary endoscopic approaches complementing or in many cases replacing open approaches. Aggressive, combined modality therapy appears to be justified in patients at greatest risk of developing recurrence based on advanced tumor stage and high pathologic grade. ONB requires prolonged surveillance following treatment given its tendency for late recurrence.<a class="elsevierStyleCrossRefs" href="#bib0295">21,22</a>The role of neoadjuvant chemotherapy (NACT) or posterior adjuvant chemotherapy (ACT) remains unclear. Many studies have tried many different chemotherapy protocols to improve survival rates without any clear results.<a class="elsevierStyleCrossRefs" href="#bib0305">23–27</a> In palliative series a positive response to platinum and etoposide regimens have been reported.<a class="elsevierStyleCrossRefs" href="#bib0215">5,28–31</a> Recently there are studies that report approximately 80% of tumoral response in locally advanced (Kadish C) cases with NACT, administrating 2 cycles of platinum and etoposide, which allows better surgical control and increases OS and DFS.<a class="elsevierStyleCrossRef" href="#bib0350">32</a>Prognosis of ONB has been reported from an analysis of 311 cases between 1973 and 2010 in the Surveillance, Epidemiology and End Results (SEER), with a Hyams I/II and III/IV correlation, having a 10-year survival rate of 67% and 34% respectively.<a class="elsevierStyleCrossRef" href="#bib0200">2</a> Recently, shorter but more actual series have reported 5 and 10-year survival rates ranging from 70 to 90%.<a class="elsevierStyleCrossRefs" href="#bib0350">32–36</a>Materials and methodsPatient dataAll patients treated for ONB at our center between the years 2008 and 2015 were included in this study. Nine patients were identified within this time interval, and their clinical records were accessed for review. Kadish system was used for staging. Every patient had a preoperative CT scan, MRI and in Kadish C patients, also a PET/CT scan was performed.All patients were treated with curative intention. Depending on each case, management of the primary tumor consisted in surgery-alone, surgery with ART or NACT followed by surgery with ART. Mean follow-up was 52.5 months (range 10–107 months).Treatment protocolIn all 9 cases, curative intended surgery was performed. Additional treatment with NACT or ART were added depending on the case according to the Kadish staging system. Intracranial extension included dural involvement with or without brain invasion.Chemotherapy: NACT in cases of Kadish C with intracranial extension was a baseline of a 3-cycled cisplatin (20mg/m2), etoposide (75mg/m2) and ifosfamide (1000mg/m2) regimen was applied before surgery and treatment response was evaluated with an MRI 4 weeks after last dose.Patients affected with intracranial extension, treatment with NACT followed by radical surgery and ART was applied. Kadish C patients with isolated orbital extension were treated with radical surgery followed by ART. No Kadish D stage patients were reported.Surgery: For Kadish A and B, endoscopic surgical approach was performed adding ART in cases of affected resection margins.For Kadish C cases with isolated orbital extension endoscopic and lateral rhinotomy approach was performed. In Kadish C cases with isolated intracranial extension an endoscopic plus bifrontal craniotomy approach was elected. The only case of Kadish C with intracranial and orbital extension was approached with both lateral rhinotomy and bifrontal craniotomy.Radiotherapy: ART was administered in all cases as intensity-modulated radiotherapy (IMRT) with a total dose between 60 and 66 grays (Gy), given in 2Gy per dose divided in 30–33 doses.Statistical analysisEstimations of OS and disease free survival DFS after curative intended treatment were performed. DFS was defined as the period of time after surgical resection that the patient survives without any signs or symptoms of ONB, while OS correspond to the length of time from surgical resection to death of any cause. For calculating DFS and OS a Kaplan– Meier method was performed using MedCalc Pro statistical analysis program.ResultsA total of 9 patients diagnosed with ONB were treated with curative intention in our institution between 2008 and 2015. Surgeries were performed by the same surgeons, 3 ORL-HNS and 1 neurosurgeon.Average age at diagnosis was 55 years old (range 28–79), 5 male and 4 females. Mean follow-up was 52.5 months (range 10–107).One patient (11%) was staged as Kadish A; 2 (22%) as Kadish B; 6 (67%) as Kadish C; and no patient (0%) as Kadish D (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). Importance on differentiate Kadish C stage with or without intracranial extension has been reported. 4 of 6 patients (67%) had intracranial extension at the moment of diagnosis.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>Hyams grade was used for histological grading, 5 patients (56%) were classified as low-grade tumors and 4 (44%) were assessed as high-grade tumors.Three different treatment modalities were reported during this study. Surgery alone was performed in 2 patients (22%), surgery with ART in 3 patients (33%) and NACT followed by surgery and ART in 4 of them (44%).Clinical and image based follow up was performed in every patient on this series, with a mean of 52.5 months (range 10–107 months). Initial treatment was defined by Kadish stage, being endoscopic surgery in Kadish A–B cases followed by ART depending on margin affection. The Kadish A case (100%) was treated with endoscopic surgery. Kadish B cases were both treated with endoscopic surgery, and 1 (50%) required ART. Patients who had intracranial extension primary treatment consisted in NACT followed by surgery and ART. On these cases surgical endoscopic and craniofacial approach were performed in 3 cases and craniofacial approach in 1 case. From the 6 Kadish C patients, 4 (67%) had intracranial extension and 2 (33%) presented isolated orbital extension, 1 case was resected endoscopically and the other endoscopic plus lateral rhinotomy approach was necessary. Both cases received ART (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>).<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>To estimate overall (OS) and disease free survival (DFS), Kaplan–Meier survival analysis was performed. Of the 9 patients, 1 (11.1%) died from the disease at 40 months of follow-up, the other 8 (88.9%) were still alive and disease free at the end of follow-up. Mean DFS of this series was 95 months (standard error [SE]=11.209; 95% confidence interval [CI]: 73.142–117.081) with a 5 and 10-year DFS of 88.9% (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Mean OS of the same series was 96 months (standard error [SE]=10.194; 95% confidence interval [CI]: 75.854–115.813), with a 5 and 10-year OS of 88.9% (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). No recurrence has been observed during follow up.<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia>DiscussionThe optimal treatment modality of ONB is still controversial due to limited series of cases and many treatment incongruences between publications in the current literature. The objective of this study expose a case series in order to add more evidence to the current literature for future reviews.Recent series highlight the importance of endoscopic approach, that anterior skull base tumors are in reach to be controlled with correct oncological margins with endoscopic resection.<a class="elsevierStyleCrossRef" href="#bib0375">37</a> In a meta-analysis, comparing 49 studies with 361 cases of ONB between 1992 and 2008, greater survival rates were demonstrated with endoscopic resection than with open surgery.<a class="elsevierStyleCrossRef" href="#bib0380">38</a> Surgical management of ONB is continuously evolving, with contemporary endoscopic approaches complementing or in many cases replacing open approaches. Aggressive, combined modality therapy appears to be justified in patients at greatest risk of developing recurrence based on advanced tumor stage and high pathologic grade. ONB requires prolonged surveillance following treatment given its tendency for late recurrence.<a class="elsevierStyleCrossRefs" href="#bib0295">21,22</a>NACT has been reported to have positive response in locally advanced ONB patients. Recent studies propose cisplatin-based treatment in combination with etoposide in a 2–4 cycled CT regimen to be the protocol with best results.Fitzek et al. in 2002 used a cisplatin (33mg/m2) and etoposide (100mg/m2) regimen for 2 cycles in Kadish B and C cases as neoadjuvant therapy, obtaining a post radical primary tumor resection 5-year DFS and OS of 88% and 74% respectively.<a class="elsevierStyleCrossRef" href="#bib0305">23</a>Kim et al. in 2004 tried NACT in 11 patients with ONB, regimen consisted in cisplatin (20mg/m2), etoposide (75mg/m2) and ifosfamide (1000mg/m2) for a median of 4 cycles. Achieving a tumor reduction (>50%) response rate of 82%.<a class="elsevierStyleCrossRef" href="#bib0340">30</a>Furthermore, Patil et al. have also used a NACT regimen with cisplatin (33mg/m2) and etoposide (100mg/m2) for a total of 2 cycles. The tumor reduction (>50%) response rate observed was 80%. After radical treatment of the primary tumor, a 5-year DFS and OS of 75% and 78.5% were obtained.<a class="elsevierStyleCrossRef" href="#bib0350">32</a>Patients with intracranial extension were treated with NACT on this series. A baseline of a 3-cycled cisplatin (20mg/m2), etoposide (75mg/m2) and ifosfamide (1000mg/m2) regimen was applied obtaining a tumor reduction (>50%) response rate of 75%. A 5-year DFS and OS of 88.9% were achieved.An actual retrospective studies review indicates that in locally advanced ONB cases, particularly in those with intracranial extension, NACT followed by radical treatment of the primary tumor seem to improve the 5-year DFS and OS.Multidisciplinary management of this entity seems to be necessary. Surgery is still the main line of treatment, and minimally invasive endoscopic resection appears to be the preferred choice over more invasive approaches.It has been seen that surgery and ART increases OS and DFS in relation to surgery or RT alone,<a class="elsevierStyleCrossRef" href="#bib0270">16</a> specially in locally advanced or in cases with affected resection margins.On the current literature, multiple retrospective studies affirm that NACT could be an important line of treatment in tumors which resection is difficult such as locally advanced cases with intracranial extension.Priority was given to endoscopic surgery versus mixed or craniofacial approach if a complete endoscopic resection could be achievable. ART was reserved for Kadish A or B cases with affected resection margins and for every Kadish C case. NACT was indicated in selected locally advanced cases with intracranial extension for the difficulty of the resection that overcomes with it.Like most of ONB series reported in the literature, this is also a retrospective observational study and it has their own intrinsic limitations. We agree that more studies with better level of evidence are needed.ConclusionIn the actual days NACT has been an improvement for OS a DFS in ONB series since it has been systematically used in large locally advanced tumors. There are no randomized trials or high level evidence due to its infrequency and the vast majority of the studies are retrospective studies with limited amount of patients.It has been seen that NACT is an effective therapy for tumor reduction in olfactory neuroblastomas, allowing surgeons to achieve better surgical resection margins and reducing its complications. An increase of OS and DFS between 70 and 90% was observed in the latest series.Complete endoscopic resection can be achieved in Kadish A, B and resecable Kadish C tumors. Although open approaches might be necessary for complete resection in more extensive neoplasms. The tendency is to avoid open approaches and try to manage a fully endoscopic resection in order to minimize postoperative complications.We agree that more high level evidence is needed to unify concepts and develop treatment protocols for this rare kind of tumor.Conflict of interestThe authors declare no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1063362" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1011598" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1063363" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1011599" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Patient data" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Treatment protocol" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflict of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-03-28" "fechaAceptado" => "2017-07-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1011598" "palabras" => array:5 [ 0 => "Esthesioneuroblastoma" 1 => "Olfactory neuroblastoma" 2 => "Neoadjuvant chemotherapy" 3 => "Endoscopic surgery" 4 => "Adjuvant radiotherapy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1011599" "palabras" => array:5 [ 0 => "Estesioneuroblastoma" 1 => "Neuroblastoma olfatorio" 2 => "Quimioterapia neoadyuvante" 3 => "Resección endoscópica" 4 => "Radioterapia adyuvante" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "Introduction and objectivesOlfactory neuroblastoma (ONB) is a rare entity that constitutes less than 5% of nasosinusal malignancies. Mainstream treatment consists in surgical resection+/−adjuvant radiotherapy. By exposing results observed with apparition of new therapeutic options as neoadjuvant chemotherapy, the objective is to evaluate a series and a review of the current literature. MethodsA retrospective review was conducted including patients diagnosed and followed-up for ONB from 2008 to 2015 in our institution. Results9 patients were included. Mean follow-up of 52.5 months (range 10–107). Kadish stage: A, 1 patient (11.1%) treated with endoscopic surgery; B, 2 patients (22.2%) treated with endoscopic surgery (one of them received adjuvant radiotherapy); C, 6 patients (66.7%), 4 patients presented intracranial extension and were treated with neoadjuvant chemotherapy followed by surgery and radiotherapy. The other 2 patients presented isolated orbital extension, treated with radical surgery (endoscopic or craniofacial resection) plus radiotherapy. The 5-year disease free and overall survival observed was 88.9%. ConclusionNeoadjuvant chemotherapy could be an effective treatment for tumor reduction, improving surgical resection and reducing its complications." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "Introducción y objetivosElneuroblastoma olfatorio es una entidad rara que se corresponde con menos del 5% de las neoplasias nasosinusales. El tratamiento principal consiste en la resección quirúrgica±radioterapia adyuvante. El objetivo es evaluar la sobrevida en una serie de casos y la literatura actual, mostrando resultados observados con la aparición de nuevas opciones terapéuticas como la quimioterapia neoadyuvante. MétodosSe realizó un estudio retrospectivo incluyendo pacientes tratados y seguidos en nuestro centro desde 2008 a 2015. ResultadosDentro del estudio fueron incluidos 9 pacientes. El seguimiento medio fue de 52,5 meses (rango 10-107). Estadio Kadish: A) un paciente (11,1%) fue tratado con resección endoscópica; B) 2 pacientes (22,2%) tratados con resección endoscópica (uno de ellos recibió radioterapia adyuvante); C) 6 pacientes (66,7%), de los cuales 4 presentaron extensión intracraneal y fueron tratados con quimioterapia neoadyuvante, cirugía y radioterapia adyuvante. Los otros 2 pacientes presentaron invasión intraorbitaria aislada, tratados con cirugía radical y radioterapia adyuvante. La sobrevida y periodo libre de enfermedad a 5 años fue del 88,9%. ConclusiónLa quimioterapia neoadyuvante puede ser un tratamiento efectivo para la reducción del tamaño tumoral, mejorando la resección quirúrgica y reduciendo sus complicaciones." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "The authors certify that they have no affiliations or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript." ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1111 "Ancho" => 1473 "Tamanyo" => 133958 ] ] "descripcion" => array:1 [ "en" => "Disease free survival." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1105 "Ancho" => 1423 "Tamanyo" => 127447 ] ] "descripcion" => array:1 [ "en" => "Overall survival." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Stage \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Extension \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Confined to the nasal cavity \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Involvement of one or more paranasal sinuses \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Extension beyond the nasal cavity and paranasal sinuses involving cribriform lamina, skull base, orbit or intracranial cavity \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">D \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Regional lymph node or distant metastasis \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1812987.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Kadish staging system." ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Stage \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Extension \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Tumor involving the nasal cavity and/or paranasal sinuses (excluding sphenoid), sparing the most superior ethmoidal cells \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Tumor involving the nasal cavity and/or paranasal sinuses (including the sphenoid) with extension to or erosion of the cribiform plate \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Tumor extending into the orbit or protruding into the anterior cranial fossa \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Tumor involving the brain \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">N0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No cervical lymph node involvement \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">N1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cervical lymph node metastasis present \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No distant metastases \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Distant metastases present \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1812986.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Dulguerov staging system." ] ] 4 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Stage \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">N \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Hyams</th></tr><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Kadish \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Low grade (I-II) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">High grade (III–IV) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (11%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (100%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (22%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (100%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (67%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">-Intracranial extension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (44%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (25%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (75%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">-Orbital extension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (33%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (33%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (67%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">D \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1812985.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Hyams grade." ] ] 5 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "DF: disease free. NACT: neoadjuvant chemotherapy. ART: adjuvant radiotherapy." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Kadish \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hyams \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Extension \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NACT \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Surgery \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Approach \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ART \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Follow-up (months) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Status \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Endoscopic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">107 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive and DF \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Endoscopic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive and DF \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Endoscopic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive and DF \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Orbit \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Endoscopic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive and DF \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Orbit \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive and DF \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">IC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">85 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive and DF \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">IC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive and DF \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">IC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive and DF \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Orbit and IC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Craniofacial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dead of disease \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1812988.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Patient results." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:38 [ 0 => array:3 [ "identificador" => "bib0195" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Neuroectodermal tumours" ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:2 [ "titulo" => "Pathology and genetics of head and neck tumours" "serieFecha" => "2005" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0200" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Esthesioneuroblastoma: a population-based analysis of survival and prognostic factors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Jethanamest" 1 => "L.G. Morris" 2 => "A.G. Sikora" 3 => "D.I. Kutler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archotol.133.3.276" "Revista" => array:5 [ "tituloSerie" => "Arch Otolaryngol Head Neck Surg" "fecha" => "2007" "volumen" => "133" "paginaInicial" => "276" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17372086" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0205" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Esthesioneuroblastoma: results and outcomes of a single institution's experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P.D. Ward" 1 => "J.A. Heth" 2 => "B.G. Thompson" 3 => "L.J. Marentette" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-0028-1096195" "Revista" => array:5 [ "tituloSerie" => "Skull Base" "fecha" => "2009" "volumen" => "19" "paginaInicial" => "133" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19721769" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0210" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Olfactory neuroblastoma: the 22-year experience at one comprehensive cancer center" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.M. Diaz Jr." 1 => "R.H. Johnigan 3rd" 2 => "C. Pero" 3 => "A.K. El-Naggar" 4 => "D.B. Roberts" 5 => "J.L. Barker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hed.20127" "Revista" => array:6 [ "tituloSerie" => "Head Neck" "fecha" => "2005" "volumen" => "27" "paginaInicial" => "138" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15654688" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1751991815000376" "estado" => "S300" "issn" => "17519918" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0215" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Esthesioneuroblastoma: the Johns Hopkins experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "V.A. Resto" 1 => "D.W. Eisele" 2 => "A. Forastiere" 3 => "M. Zahurak" 4 => "D.J. Lee" 5 => "W.H. Westra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Head Neck" "fecha" => "2000" "volumen" => "22" "paginaInicial" => "550" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10941155" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0220" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Esthesioneuroblastoma: the Princess Margaret Hospital experience" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Bachar" 1 => "D.P. Goldstein" 2 => "M. Shah" 3 => "A Tandon" 4 => "J. Ringash" 5 => "G. Pond" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hed.20920" "Revista" => array:5 [ "tituloSerie" => "Head Neck" "fecha" => "2008" "volumen" => "30" "paginaInicial" => "1607" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18798301" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0225" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Two cases of ectopic adrenocorticotropic hormone syndrome with olfactory neuroblastoma and literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.K. Koo" 1 => "J.H. An" 2 => "K.H. Jeon" 3 => "S.H. Choi" 4 => "Y.M. Cho" 5 => "H.C. Jang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Endocr J" "fecha" => "2008" "volumen" => "55" "paginaInicial" => "469" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18469486" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0230" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Olfactory neuroblastoma. A clinical analysis of 17 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Kadish" 1 => "M. Goodman" 2 => "C.C. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Cancer" "fecha" => "1976" "volumen" => "37" "paginaInicial" => "1571" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1260676" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0235" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Computed tomography and magnetic resonance imaging features of olfactory neuroblastoma: an analysis of 22 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Pickuth" 1 => "S.H. Heywang-Köbrunner" 2 => "R.P. Spielmann" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Otolaryngol Allied Sci" "fecha" => "1999" "volumen" => "24" "paginaInicial" => "457" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10542931" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0168822715002557" "estado" => "S300" "issn" => "01688227" ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0240" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MRI of esthesioneuroblastoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.P. Derdeyn" 1 => "C.J. Moran" 2 => "F.J. Wippold 2nd." 3 => "D.P. Chason" 4 => "M.B. Koby" 5 => "F. Rodriguez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Comput Assist Tomogr" "fecha" => "1994" "volumen" => "18" "paginaInicial" => "16" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8282874" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0245" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging of olfactory neuroblastoma – an analysis of 17 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K.J. Kairemo" 1 => "A.P. Jekunen" 2 => "M.S. Kestilä" 3 => "H.A. Ramsay" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Auris Nasus Larynx" "fecha" => "1998" "volumen" => "25" "paginaInicial" => "173" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9673731" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0250" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The added value of 18F-FDG PET/CT for evaluation of patients with esthesioneuroblastoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.M. Broski" 1 => "C.H. Hunt" 2 => "G.B. Johnson" 3 => "R.M. Subramaniam" 4 => "P.J. Peller" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2967/jnumed.112.102897" "Revista" => array:5 [ "tituloSerie" => "J Nucl Med" "fecha" => "2012" "volumen" => "53" "paginaInicial" => "1200" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22728262" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0255" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term follow-up using 18F-FDG PET/CT for postoperative olfactory neuroblastoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Fujioka" 1 => "A. Toriihara" 2 => "K. Kubota" 3 => "Y. Machida" 4 => "S. Nakamura" 5 => "S. Kishimoto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MNM.0000000000000135" "Revista" => array:6 [ "tituloSerie" => "Nucl Med Commun" "fecha" => "2014" "volumen" => "35" "paginaInicial" => "857" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24751700" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0168822713003859" "estado" => "S300" "issn" => "01688227" ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0260" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Esthesioneuroblastoma: the University of Iowa experience 1978–1998" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.H. Simon" 1 => "W. Zhen" 2 => "T.M. McCulloch" 3 => "H.T. Hoffman" 4 => "A.C. Paulino" 5 => "N.A. Mayr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/00005537-200103000-00020" "Revista" => array:5 [ "tituloSerie" => "Laryngoscope" "fecha" => "2001" "volumen" => "111" "paginaInicial" => "488" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11224781" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0265" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Esthesioneuroblastoma: the massachusetts eye and ear infirmary and massachusetts general hospital experience with craniofacial resection, proton beam radiation, and chemotherapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.C. Nichols" 1 => "A.W. Chan" 2 => "W.T. Curry" 3 => "F.G. Barker" 4 => "D.G. Deschler" 5 => "D.T. Lin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-2008-1076098" "Revista" => array:5 [ "tituloSerie" => "Skull Base" "fecha" => "2008" "volumen" => "18" "paginaInicial" => "327" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19240832" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0270" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiotherapy alone for local tumour control in esthesioneuroblastoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Benfari" 1 => "M. Fusconi" 2 => "A. Ciofalo" 3 => "A. Gallo" 4 => "G. Altissimi" 5 => "T. Celani" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Otorhinolaryngol Ital" "fecha" => "2008" "volumen" => "28" "paginaInicial" => "292" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19205593" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0275" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Combined endoscopic surgery and radiosurgery as treatment modality for olfactory neuroblastoma (esthesioneuroblastoma)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F. Unger" 1 => "K. Haselsberger" 2 => "C. Walch" 3 => "H Stammberger" 4 => "G. Papaefthymiou" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "2005" "volumen" => "147" "paginaInicial" => "595" "itemHostRev" => array:3 [ "pii" => "S0168822711002312" "estado" => "S300" "issn" => "01688227" ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0280" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endoscopic endonasal resection of esthesioneuroblastoma: a multicenter study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Folbe" 1 => "I. Herzallah" 2 => "U. Duvvuri" 3 => "M. Bublik" 4 => "Z. Sargi" 5 => "C.H. Snyderman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2500/ajra.2009.23.3269" "Revista" => array:6 [ "tituloSerie" => "Am J Rhinol Allergy" "fecha" => "2009" "volumen" => "23" "paginaInicial" => "91" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19379620" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0033350617302111" "estado" => "S300" "issn" => "00333506" ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0285" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endoscopic versus traditional craniofacial resection for patients with sinonasal tumors involving the anterior skull base" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.J. Kim" 1 => "D.W. Kim" 2 => "S.W. Kim" 3 => "D.H. Han" 4 => "D.-Y. Kim" 5 => "C.-S. Rhee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3342/ceo.2008.1.3.148" "Revista" => array:5 [ "tituloSerie" => "Clin Exp Otorhinolaryngol" "fecha" => "2008" "volumen" => "1" "paginaInicial" => "148" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19434247" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0290" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endoscopic surgery for malignant tumors of the sinonasal tract and adjacent skull base: a 10-year experience" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Nicolai" 1 => "P. Battaglia" 2 => "M. Bignami" 3 => "A. Bolzoni Villaret" 4 => "G. Delù" 5 => "T. Khrais" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2500/ajr.2008.22.3170" "Revista" => array:5 [ "tituloSerie" => "Am J Rhinol" "fecha" => "2008" "volumen" => "22" "paginaInicial" => "308" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18588765" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0295" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contemporary management of esthesioneuroblastoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.S. Schwartz" 1 => "J.N. Palmer" 2 => "N.D. Adappa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MOO.0000000000000220" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Otolaryngol Head Neck Surg" "fecha" => "2016" "volumen" => "24" "paginaInicial" => "63" "paginaFinal" => "69" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26575517" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0300" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endoscopic management of esthesioneuroblastoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.R. Roxbury" 1 => "M. Ishii" 2 => "G.L. Gallia" 3 => "D.D. Reh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.otc.2015.09.010" "Revista" => array:6 [ "tituloSerie" => "Otolaryngol Clin North Am" "fecha" => "2016" "volumen" => "49" "paginaInicial" => "153" "paginaFinal" => "165" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26614835" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0305" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neuroendocrine tumors of the sinonasal tract. Results of a prospective study incorporating chemotherapy, surgery, and combined proton-photon radiotherapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.M. Fitzek" 1 => "A.F. Thornton" 2 => "M. Varvares" 3 => "M. Ancukiewicz" 4 => "J. Mcintyre" 5 => "J. Adams" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Cancer" "fecha" => "2002" "volumen" => "94" "paginaInicial" => "2623" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12173330" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0310" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multimodality therapy including radiotherapy and chemotherapy improves event-free survival in stage C esthesioneuroblastoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.T. Eich" 1 => "B. Hero" 2 => "S. Staar" 3 => "O. Micke" 4 => "H. Seegenschmiedt" 5 => "A. Mattke" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00066-003-1089-x" "Revista" => array:5 [ "tituloSerie" => "Strahlenther Onkol" "fecha" => "2003" "volumen" => "179" "paginaInicial" => "233" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12707712" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0315" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Olfactory neuroblastoma: the results of modern treatment approaches at the University of Michigan" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.J. Zappia" 1 => "W.R. Carroll" 2 => "G.T. Wolf" 3 => "A.F. Thornton" 4 => "L. Ho" 5 => "C.J. Krause" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Head Neck" "fecha" => "1993" "volumen" => "15" "paginaInicial" => "190" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8491582" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0320" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Esthesioneuroblastoma: continued follow-up of a single institution's experience" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.H. Loy" 1 => "J.F. Reibel" 2 => "P.W. Read" 3 => "CY. Thomas" 4 => "S.A. Newman" 5 => "J.A. Jane" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archotol.132.2.134" "Revista" => array:6 [ "tituloSerie" => "Arch Otolaryngol Head Neck Surg" "fecha" => "2006" "volumen" => "132" "paginaInicial" => "134" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16490869" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0168822716301036" "estado" => "S300" "issn" => "01688227" ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0325" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Esthesioneuroblastoma: the Northwestern University experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Argiris" 1 => "J. Dutra" 2 => "P. Tseke" 3 => "K. Haines" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/00005537-200301000-00029" "Revista" => array:5 [ "tituloSerie" => "Laryngoscope" "fecha" => "2003" "volumen" => "113" "paginaInicial" => "155" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12514401" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0330" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Combination chemotherapy (cyclophosphamide, doxorubicin, and vincristine with continuous-infusion cisplatin and etoposide) and radiotherapy with stem cell support can be beneficial for adolescents and adults with estheisoneuroblastoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Mishima" 1 => "E. Nagasaki" 2 => "Y. Terui" 3 => "T. Irie" 4 => "S. Takahashi" 5 => "Y. Ito" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.20471" "Revista" => array:5 [ "tituloSerie" => "Cancer" "fecha" => "2004" "volumen" => "101" "paginaInicial" => "1437" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15368332" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0335" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of intracranial metastatic esthesioneuroblastoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.C. Chamberlain" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.10679" "Revista" => array:5 [ "tituloSerie" => "Cancer" "fecha" => "2002" "volumen" => "95" "paginaInicial" => "243" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12124822" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0340" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neoadjuvant etoposide, ifosfamide, and cisplatin for the treatment of olfactory neuroblastoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.W. Kim" 1 => "Y.H. Jo" 2 => "J.H. Kim" 3 => "H.G. Wu" 4 => "C.S. Rhee" 5 => "C.H. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.20648" "Revista" => array:5 [ "tituloSerie" => "Cancer" "fecha" => "2004" "volumen" => "101" "paginaInicial" => "2257" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15484215" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0345" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Advanced adult esthesioneuroblastoma successfully treated with cisplatin and etoposide alternated with doxorubicin, ifosfamide and vincristine" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Turano" 1 => "C. Mastroianni" 2 => "C. Manfredi" 3 => "R. Biamonte" 4 => "S. Ceniti" 5 => "V. Liguori" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11060-009-0052-9" "Revista" => array:5 [ "tituloSerie" => "J Neurooncol" "fecha" => "2010" "volumen" => "98" "paginaInicial" => "131" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19924514" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0350" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "neoadjuvant chemotherapy in locally advanced and borderline resectable nonsquamous sinonasal tumors (esthesioneuroblastoma and sinonasal tumor with neuroendocrine differentiation)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V.M. Patil" 1 => "A. Joshi" 2 => "V. Noronha" 3 => "V. Sharma" 4 => "S. Zanwar" 5 => "S. Dhumal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2016/6923730" "Revista" => array:6 [ "tituloSerie" => "Int J Surg Oncol" "fecha" => "2016" "volumen" => "2016" "paginaInicial" => "6923730" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26955484" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S2214999615012680" "estado" => "S300" "issn" => "22149996" ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0355" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Esthesioneuroblastoma: an update on the UCLA experience, 2002–2013" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.A. Tajudeen" 1 => "A. Arshi" 2 => "J.D. Suh" 3 => "M.F. Palma-Diaz" 4 => "M. Bergsneider" 5 => "E. Abemayor" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-0034-1390011" "Revista" => array:5 [ "tituloSerie" => "J Neurol Surg B Skull Base" "fecha" => "2015" "volumen" => "76" "paginaInicial" => "43" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25685649" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0360" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multidisciplinary treatment of olfactory neuroblastoma: patterns of failure and management of recurrence" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G.J. Petruzzelli" 1 => "J.B. Howell" 2 => "A. Pederson" 3 => "T.C. Origitano" 4 => "R.W. Byrne" 5 => "L. Munoz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjoto.2015.02.008" "Revista" => array:5 [ "tituloSerie" => "Am J Otolaryngol" "fecha" => "2015" "volumen" => "36" "paginaInicial" => "547" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25749259" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0365" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic utility of Hyams histological grading and Kadish-Morita staging systems for esthesioneuroblastoma outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Bell" 1 => "R. Saade" 2 => "D. Roberts" 3 => "T.J. Ow" 4 => "M. Kupferman" 5 => "F. DeMonte" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12105-014-0547-3" "Revista" => array:6 [ "tituloSerie" => "Head Neck Pathol" "fecha" => "2015" "volumen" => "9" "paginaInicial" => "51" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24806334" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1751991817301109" "estado" => "S300" "issn" => "17519918" ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0370" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Olfactory neuroblastoma: a 35-year experience and suggested follow-up protocol" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Rimmer" 1 => "V.J. Lund" 2 => "T. Beale" 3 => "W.I. Wei" 4 => "D. Howard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/lary.24562" "Revista" => array:6 [ "tituloSerie" => "Laryngoscope" "fecha" => "2014" "volumen" => "124" "paginaInicial" => "1542" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24347437" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0168822714003088" "estado" => "S300" "issn" => "01688227" ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0375" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endoscopic skull base surgery: principles of endonasal oncological surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.H. Snyderman" 1 => "R.L. Carrau" 2 => "A.B. Kassam" 3 => "A. Zanation" 4 => "D. Prevedello" 5 => "P. Gardner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jso.21020" "Revista" => array:6 [ "tituloSerie" => "J Surg Oncol" "fecha" => "2008" "volumen" => "97" "paginaInicial" => "658" "paginaFinal" => "664" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18493946" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0380" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of esthesioneuroblastoma: a 16-year meta-analysis of 361 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.K. Devaiah" 1 => "M.T. Adfreoli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/lary.20280" "Revista" => array:6 [ "tituloSerie" => "Laryngoscope" "fecha" => "2009" "volumen" => "119" "paginaInicial" => "1412" "paginaFinal" => "1416" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19444891" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735735/0000006900000004/v1_201807220439/S2173573518300553/v1_201807220439/en/main.assets" "Apartado" => array:4 [ "identificador" => "5871" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735735/0000006900000004/v1_201807220439/S2173573518300553/v1_201807220439/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573518300553?idApp=UINPBA00004N"]

Statistics

Original article

Importance of neoadjuvant chemotherapy in olfactory neuroblastoma treatment: Series report and literature review

Importancia de la quimioterapia neoadyuvante en el tratamiento del neuroblastoma olfatorio: serie de casos y revisión de la literatura

Ricardo Bartela,

Corresponding author

pilobartel@gmail.com

Corresponding author.

, Xavier Gonzalez-Comptaa, Enric Cisaa, Francesc Cruellasa, Alberto Torresb, Aleix Roviraa, Manel Manosa

a ORL-HNS Department, Hospital Universitari de Bellvitge, Barcelona, Spain

b Neurosurgery Department, Hospital Universitari de Bellvitge, Barcelona, Spain

Read

174

Times
was read the article

Total PDF

113

Total HTML

Share statistics

 array:23 [
  "pii" => "S2173573518300553"
  "issn" => "21735735"
  "doi" => "10.1016/j.otoeng.2017.07.003"
  "estado" => "S300"
  "fechaPublicacion" => "2018-07-01"
  "aid" => "826"
  "copyright" => "Sociedad Espa&#241;ola de Otorrinolaringolog&#237;a y Cirug&#237;a de Cabeza y Cuello"
  "copyrightAnyo" => "2017"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Acta Otorrinolaringol Esp. 2018;69:208-13"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 164
    "formatos" => array:3 [
      "EPUB" => 42
      "HTML" => 89
      "PDF" => 33
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173573518300498"
    "issn" => "21735735"
    "doi" => "10.1016/j.otoeng.2017.08.010"
    "estado" => "S300"
    "fechaPublicacion" => "2018-07-01"
    "aid" => "831"
    "copyright" => "Sociedad Espa&#241;ola de Otorrinolaringolog&#237;a y Cirug&#237;a de Cabeza y Cuello"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Acta Otorrinolaringol Esp. 2018;69:214-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 231
      "formatos" => array:3 [
        "EPUB" => 82
        "HTML" => 100
        "PDF" => 49
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Analysis of Audiometric Relapse-Free Survival in Patients With Immune-Mediated Hearing Loss Exclusively Treated With Corticosteroids"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "214"
          "paginaFinal" => "218"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "An&#225;lisis de supervivencia libre de reca&#237;da audiom&#233;trica en pacientes con hipoacusia inmunomediada tratados exclusivamente con corticoides"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1180
              "Ancho" => 1497
              "Tamanyo" => 71116
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Function of survival distribution of the relapse event &#40;Kaplan Meier&#41;&#44; limited by the confidence intervals&#46; In the abscissa axis we observe the time in months and how&#44; as the year advances&#44; the majority of patients have relapses&#46; We have put a circle around the 4 censured patients&#44; free from relapse in the first year&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Nieves Mata-Castro, Raimon Garc&#237;a-Chilleron, Javier Gavilanes-Plasencia, Rafael Ram&#237;rez-Camacho, Alfredo Garc&#237;a-Fern&#225;ndez, Jos&#233; Ram&#243;n Garc&#237;a-Berrocal"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Nieves"
              "apellidos" => "Mata-Castro"
            ]
            1 => array:2 [
              "nombre" => "Raimon"
              "apellidos" => "Garc&#237;a-Chilleron"
            ]
            2 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Gavilanes-Plasencia"
            ]
            3 => array:2 [
              "nombre" => "Rafael"
              "apellidos" => "Ram&#237;rez-Camacho"
            ]
            4 => array:2 [
              "nombre" => "Alfredo"
              "apellidos" => "Garc&#237;a-Fern&#225;ndez"
            ]
            5 => array:2 [
              "nombre" => "Jos&#233; Ram&#243;n"
              "apellidos" => "Garc&#237;a-Berrocal"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001651917301747"
        "doi" => "10.1016/j.otorri.2017.08.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001651917301747?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573518300498?idApp=UINPBA00004N"
    "url" => "/21735735/0000006900000004/v1_201807220439/S2173573518300498/v1_201807220439/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173573518300346"
    "issn" => "21735735"
    "doi" => "10.1016/j.otoeng.2017.06.014"
    "estado" => "S300"
    "fechaPublicacion" => "2018-07-01"
    "aid" => "817"
    "copyright" => "Sociedad Espa&#241;ola de Otorrinolaringolog&#237;a y Cirug&#237;a de Cabeza y Cuello"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Acta Otorrinolaringol Esp. 2018;69:201-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 349
      "formatos" => array:3 [
        "EPUB" => 25
        "HTML" => 243
        "PDF" => 81
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Efficacy of Particle Repositioning Manoeuvres in Benign Positional Paroxysmal Vertigo&#58; A Revision of 176 Cases Treated in a Tertiary Care Centre"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "201"
          "paginaFinal" => "207"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Eficacia de las maniobras de reposicionamiento canalicular en el v&#233;rtigo posicional parox&#237;stico benigno&#58; revisi&#243;n de 176 casos tratados en un centro hospitalario de tercer nivel"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0025"
          "etiqueta" => "Figure 5"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr5.jpeg"
              "Alto" => 1328
              "Ancho" => 1610
              "Tamanyo" => 73738
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Lempert &#40;or &#8220;barbeque&#8221;&#41; manoeuvre&#58; the affected left ear &#40;black&#41;&#46; 1&#46; In the first movement the patient is in a lateral decubitus position towards the affected side&#46; 2&#46; The body is then rotated 90&#176; towards the right&#46; 3&#46; The body is then rotated 180&#176; towards the right&#46; 4&#46; Lastly the body is rotated 270&#176; towards the right&#44; so that the patient is face down&#46; 5&#46; The next step is to turn the body 360&#176; towards the right&#44; with the patient being in the original position&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Claudio Carnevale, Diego J&#46; Arancibia-Tagle, Elena Rizzo-Riera, Guillermo Til-Perez, Pedro L&#46; Sarr&#237;a-Echegaray, Julio J&#46; Rama-Lopez, Santiago Quer-Canut, German Fermin-Gamero, Manuel D&#46; Tomas-Barberan"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "Claudio"
              "apellidos" => "Carnevale"
            ]
            1 => array:2 [
              "nombre" => "Diego J&#46;"
              "apellidos" => "Arancibia-Tagle"
            ]
            2 => array:2 [
              "nombre" => "Elena"
              "apellidos" => "Rizzo-Riera"
            ]
            3 => array:2 [
              "nombre" => "Guillermo"
              "apellidos" => "Til-Perez"
            ]
            4 => array:2 [
              "nombre" => "Pedro L&#46;"
              "apellidos" => "Sarr&#237;a-Echegaray"
            ]
            5 => array:2 [
              "nombre" => "Julio J&#46;"
              "apellidos" => "Rama-Lopez"
            ]
            6 => array:2 [
              "nombre" => "Santiago"
              "apellidos" => "Quer-Canut"
            ]
            7 => array:2 [
              "nombre" => "German"
              "apellidos" => "Fermin-Gamero"
            ]
            8 => array:2 [
              "nombre" => "Manuel D&#46;"
              "apellidos" => "Tomas-Barberan"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001651917301565"
        "doi" => "10.1016/j.otorri.2017.06.001"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001651917301565?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573518300346?idApp=UINPBA00004N"
    "url" => "/21735735/0000006900000004/v1_201807220439/S2173573518300346/v1_201807220439/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Importance of neoadjuvant chemotherapy in olfactory neuroblastoma treatment&#58; Series report and literature review"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "208"
        "paginaFinal" => "213"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Ricardo Bartel, Xavier Gonzalez-Compta, Enric Cisa, Francesc Cruellas, Alberto Torres, Aleix Rovira, Manel Manos"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "Ricardo"
            "apellidos" => "Bartel"
            "email" => array:1 [
              0 => "pilobartel&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Xavier"
            "apellidos" => "Gonzalez-Compta"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Enric"
            "apellidos" => "Cisa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Francesc"
            "apellidos" => "Cruellas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Alberto"
            "apellidos" => "Torres"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Aleix"
            "apellidos" => "Rovira"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Manel"
            "apellidos" => "Manos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "ORL-HNS Department&#44; Hospital Universitari de Bellvitge&#44; Barcelona&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Neurosurgery Department&#44; Hospital Universitari de Bellvitge&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Importancia de la quimioterapia neoadyuvante en el tratamiento del neuroblastoma olfatorio&#58; serie de casos y revisi&#243;n de la literatura"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1111
            "Ancho" => 1473
            "Tamanyo" => 133958
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Disease free survival&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">ONB&#44; also known as Esthesioneuroblastoma is a rare entity of malignant neoplasm which is believed to be formed at the neuroepithelial cells of the olfactory tract&#46; It constitutes less than 5&#37; of all malignant tumors of the nasal fossa and paranasal sinuses&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">1</span></a> Mean age of presentation oscillates between 40 and 70 years old and has no gender predisposition&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">2</span></a> The most common clinical manifestation described is nasal obstruction secondary to the presence of a mass in the nasal cavity&#44; but it can debut with episodes of epistaxis&#44; rhinorrhea and&#47;or facial pain or facial fullness&#46; Clinical examination usually demonstrates a polypoid mass located in the cranial portion of the nasal cavity&#46; Depending on the extension and location of the tumor&#44; different symptomatology can be observed&#58; anosmia if it affects the cribriform plate&#59; if it has orbital extension&#44; can produce ocular pain&#44; diplopia or epiphora&#59; otalgia or otitis media with effusion if it extends to the eustachian tube&#59; cognitive&#47;behavioral changes with headaches if it extends to the anterior cranial fossa&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">3&#8211;6</span></a> Paraneoplastic syndromes are rarely described&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">7</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The diagnostic procedure requires a positive biopsy and the most commonly used staging classification is the Kadish clinical system<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">8</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#44; TNM known as Dulguerov staging system has also been described &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Hyams histological grading system grades ONB in four groups&#44; from I to IV depending on mitotic activity and necrosis&#44; being I&#47;II as low grade tumors and III&#47;IV as high grade tumors&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">ONB are slow-growing tumors with unspecific symptomatology leading to a delayed diagnosis&#46; At the moment of diagnosis most of the cases correspond to Kadish B or C stages&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">2</span></a> Imaging with MRI and CT scan are essential for staging and extension&#46; While CT gives better information about bone invasion&#44; MRI defines more accurately margins and adjacent soft tissue extension&#44; such as the anterior cranial fossa and orbital tissues&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">9&#8211;11</span></a> PET&#47;CT scan has importance in assessing extension in locally advanced Kadish C or Hyams III&#47;IV cases&#44; which have high risk of distant metastases&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">12&#44;13</span></a> Imaging studies do not differentiate ONB from other naso-sinusal neoplasms&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Differential diagnosis must include neuroendocrines carcinomas&#44; sinonasal undifferentiated carcinoma&#44; rhabdomyosarcoma&#44; melanomas and metastases&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">To this day&#44; due to the low frequency of this entity&#44; treatment has not been established by randomized clinical trials and has been only assessed by retrospective observational studies&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">14</span></a> Historically&#44; management of the primary tumor has been surgery with or without adjuvant radiotherapy &#40;ART&#41; and in selective cases&#44; also adjuvant chemotherapy &#40;ACT&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">15</span></a> It has been generally indicated in observational studies that overall survival &#40;OS&#41; and disease free survival &#40;DFS&#41; are increased when treated with surgery and RT compared to RT alone&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">16</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Related to surgical treatment&#44; two different surgical approaches have been used&#46; Endoscopic approach has the advantage of minimizing complications&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">17&#8211;20</span></a> Surgical management of ONB is continuously evolving&#44; with contemporary endoscopic approaches complementing or in many cases replacing open approaches&#46; Aggressive&#44; combined modality therapy appears to be justified in patients at greatest risk of developing recurrence based on advanced tumor stage and high pathologic grade&#46; ONB requires prolonged surveillance following treatment given its tendency for late recurrence&#46;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">21&#44;22</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The role of neoadjuvant chemotherapy &#40;NACT&#41; or posterior adjuvant chemotherapy &#40;ACT&#41; remains unclear&#46; Many studies have tried many different chemotherapy protocols to improve survival rates without any clear results&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">23&#8211;27</span></a> In palliative series a positive response to platinum and etoposide regimens have been reported&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">5&#44;28&#8211;31</span></a> Recently there are studies that report approximately 80&#37; of tumoral response in locally advanced &#40;Kadish C&#41; cases with NACT&#44; administrating 2 cycles of platinum and etoposide&#44; which allows better surgical control and increases OS and DFS&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">32</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Prognosis of ONB has been reported from an analysis of 311 cases between 1973 and 2010 in the Surveillance&#44; Epidemiology and End Results &#40;SEER&#41;&#44; with a Hyams I&#47;II and III&#47;IV correlation&#44; having a 10-year survival rate of 67&#37; and 34&#37; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">2</span></a> Recently&#44; shorter but more actual series have reported 5 and 10-year survival rates ranging from 70 to 90&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">32&#8211;36</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patient data</span><p id="par0045" class="elsevierStylePara elsevierViewall">All patients treated for ONB at our center between the years 2008 and 2015 were included in this study&#46; Nine patients were identified within this time interval&#44; and their clinical records were accessed for review&#46; Kadish system was used for staging&#46; Every patient had a preoperative CT scan&#44; MRI and in Kadish C patients&#44; also a PET&#47;CT scan was performed&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">All patients were treated with curative intention&#46; Depending on each case&#44; management of the primary tumor consisted in surgery-alone&#44; surgery with ART or NACT followed by surgery with ART&#46; Mean follow-up was 52&#46;5 months &#40;range 10&#8211;107 months&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Treatment protocol</span><p id="par0055" class="elsevierStylePara elsevierViewall">In all 9 cases&#44; curative intended surgery was performed&#46; Additional treatment with NACT or ART were added depending on the case according to the Kadish staging system&#46; Intracranial extension included dural involvement with or without brain invasion&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Chemotherapy&#58;</span> NACT in cases of Kadish C with intracranial extension was a baseline of a 3-cycled cisplatin &#40;20<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; etoposide &#40;75<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41; and ifosfamide &#40;1000<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41; regimen was applied before surgery and treatment response was evaluated with an MRI 4 weeks after last dose&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Patients affected with intracranial extension&#44; treatment with NACT followed by radical surgery and ART was applied&#46; Kadish C patients with isolated orbital extension were treated with radical surgery followed by ART&#46; No Kadish D stage patients were reported&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Surgery&#58;</span> For Kadish A and B&#44; endoscopic surgical approach was performed adding ART in cases of affected resection margins&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">For Kadish C cases with isolated orbital extension endoscopic and lateral rhinotomy approach was performed&#46; In Kadish C cases with isolated intracranial extension an endoscopic plus bifrontal craniotomy approach was elected&#46; The only case of Kadish C with intracranial and orbital extension was approached with both lateral rhinotomy and bifrontal craniotomy&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Radiotherapy&#58;</span> ART was administered in all cases as intensity-modulated radiotherapy &#40;IMRT&#41; with a total dose between 60 and 66 grays &#40;Gy&#41;&#44; given in 2<span class="elsevierStyleHsp" style=""></span>Gy per dose divided in 30&#8211;33 doses&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0085" class="elsevierStylePara elsevierViewall">Estimations of OS and disease free survival DFS after curative intended treatment were performed&#46; DFS was defined as the period of time after surgical resection that the patient survives without any signs or symptoms of ONB&#44; while OS correspond to the length of time from surgical resection to death of any cause&#46; For calculating DFS and OS a Kaplan&#8211; Meier method was performed using MedCalc Pro statistical analysis program&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0090" class="elsevierStylePara elsevierViewall">A total of 9 patients diagnosed with ONB were treated with curative intention in our institution between 2008 and 2015&#46; Surgeries were performed by the same surgeons&#44; 3 ORL-HNS and 1 neurosurgeon&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Average age at diagnosis was 55 years old &#40;range 28&#8211;79&#41;&#44; 5 male and 4 females&#46; Mean follow-up was 52&#46;5 months &#40;range 10&#8211;107&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">One patient &#40;11&#37;&#41; was staged as Kadish A&#59; 2 &#40;22&#37;&#41; as Kadish B&#59; 6 &#40;67&#37;&#41; as Kadish C&#59; and no patient &#40;0&#37;&#41; as Kadish D &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Importance on differentiate Kadish C stage with or without intracranial extension has been reported&#46; 4 of 6 patients &#40;67&#37;&#41; had intracranial extension at the moment of diagnosis&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Hyams grade was used for histological grading&#44; 5 patients &#40;56&#37;&#41; were classified as low-grade tumors and 4 &#40;44&#37;&#41; were assessed as high-grade tumors&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Three different treatment modalities were reported during this study&#46; Surgery alone was performed in 2 patients &#40;22&#37;&#41;&#44; surgery with ART in 3 patients &#40;33&#37;&#41; and NACT followed by surgery and ART in 4 of them &#40;44&#37;&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Clinical and image based follow up was performed in every patient on this series&#44; with a mean of 52&#46;5 months &#40;range 10&#8211;107 months&#41;&#46; Initial treatment was defined by Kadish stage&#44; being endoscopic surgery in Kadish A&#8211;B cases followed by ART depending on margin affection&#46; The Kadish A case &#40;100&#37;&#41; was treated with endoscopic surgery&#46; Kadish B cases were both treated with endoscopic surgery&#44; and 1 &#40;50&#37;&#41; required ART&#46; Patients who had intracranial extension primary treatment consisted in NACT followed by surgery and ART&#46; On these cases surgical endoscopic and craniofacial approach were performed in 3 cases and craniofacial approach in 1 case&#46; From the 6 Kadish C patients&#44; 4 &#40;67&#37;&#41; had intracranial extension and 2 &#40;33&#37;&#41; presented isolated orbital extension&#44; 1 case was resected endoscopically and the other endoscopic plus lateral rhinotomy approach was necessary&#46; Both cases received ART &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">To estimate overall &#40;OS&#41; and disease free survival &#40;DFS&#41;&#44; Kaplan&#8211;Meier survival analysis was performed&#46; Of the 9 patients&#44; 1 &#40;11&#46;1&#37;&#41; died from the disease at 40 months of follow-up&#44; the other 8 &#40;88&#46;9&#37;&#41; were still alive and disease free at the end of follow-up&#46; Mean DFS of this series was 95 months &#40;standard error &#91;SE&#93;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#46;209&#59; 95&#37; confidence interval &#91;CI&#93;&#58; 73&#46;142&#8211;117&#46;081&#41; with a 5 and 10-year DFS of 88&#46;9&#37; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Mean OS of the same series was 96 months &#40;standard error &#91;SE&#93;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#46;194&#59; 95&#37; confidence interval &#91;CI&#93;&#58; 75&#46;854&#8211;115&#46;813&#41;&#44; with a 5 and 10-year OS of 88&#46;9&#37; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; No recurrence has been observed during follow up&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0125" class="elsevierStylePara elsevierViewall">The optimal treatment modality of ONB is still controversial due to limited series of cases and many treatment incongruences between publications in the current literature&#46; The objective of this study expose a case series in order to add more evidence to the current literature for future reviews&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Recent series highlight the importance of endoscopic approach&#44; that anterior skull base tumors are in reach to be controlled with correct oncological margins with endoscopic resection&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">37</span></a> In a meta-analysis&#44; comparing 49 studies with 361 cases of ONB between 1992 and 2008&#44; greater survival rates were demonstrated with endoscopic resection than with open surgery&#46;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">38</span></a> Surgical management of ONB is continuously evolving&#44; with contemporary endoscopic approaches complementing or in many cases replacing open approaches&#46; Aggressive&#44; combined modality therapy appears to be justified in patients at greatest risk of developing recurrence based on advanced tumor stage and high pathologic grade&#46; ONB requires prolonged surveillance following treatment given its tendency for late recurrence&#46;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">21&#44;22</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">NACT has been reported to have positive response in locally advanced ONB patients&#46; Recent studies propose cisplatin-based treatment in combination with etoposide in a 2&#8211;4 cycled CT regimen to be the protocol with best results&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Fitzek et al&#46; in 2002 used a cisplatin &#40;33<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41; and etoposide &#40;100<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41; regimen for 2 cycles in Kadish B and C cases as neoadjuvant therapy&#44; obtaining a post radical primary tumor resection 5-year DFS and OS of 88&#37; and 74&#37; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">23</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">Kim et al&#46; in 2004 tried NACT in 11 patients with ONB&#44; regimen consisted in cisplatin &#40;20<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; etoposide &#40;75<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41; and ifosfamide &#40;1000<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41; for a median of 4 cycles&#46; Achieving a tumor reduction &#40;&#62;50&#37;&#41; response rate of 82&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">30</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Furthermore&#44; Patil et al&#46; have also used a NACT regimen with cisplatin &#40;33<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41; and etoposide &#40;100<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41; for a total of 2 cycles&#46; The tumor reduction &#40;&#62;50&#37;&#41; response rate observed was 80&#37;&#46; After radical treatment of the primary tumor&#44; a 5-year DFS and OS of 75&#37; and 78&#46;5&#37; were obtained&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">32</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">Patients with intracranial extension were treated with NACT on this series&#46; A baseline of a 3-cycled cisplatin &#40;20<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; etoposide &#40;75<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41; and ifosfamide &#40;1000<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span>&#41; regimen was applied obtaining a tumor reduction &#40;&#62;50&#37;&#41; response rate of 75&#37;&#46; A 5-year DFS and OS of 88&#46;9&#37; were achieved&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">An actual retrospective studies review indicates that in locally advanced ONB cases&#44; particularly in those with intracranial extension&#44; NACT followed by radical treatment of the primary tumor seem to improve the 5-year DFS and OS&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Multidisciplinary management of this entity seems to be necessary&#46; Surgery is still the main line of treatment&#44; and minimally invasive endoscopic resection appears to be the preferred choice over more invasive approaches&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">It has been seen that surgery and ART increases OS and DFS in relation to surgery or RT alone&#44;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">16</span></a> specially in locally advanced or in cases with affected resection margins&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">On the current literature&#44; multiple retrospective studies affirm that NACT could be an important line of treatment in tumors which resection is difficult such as locally advanced cases with intracranial extension&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Priority was given to endoscopic surgery versus mixed or craniofacial approach if a complete endoscopic resection could be achievable&#46; ART was reserved for Kadish A or B cases with affected resection margins and for every Kadish C case&#46; NACT was indicated in selected locally advanced cases with intracranial extension for the difficulty of the resection that overcomes with it&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Like most of ONB series reported in the literature&#44; this is also a retrospective observational study and it has their own intrinsic limitations&#46; We agree that more studies with better level of evidence are needed&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclusion</span><p id="par0190" class="elsevierStylePara elsevierViewall">In the actual days NACT has been an improvement for OS a DFS in ONB series since it has been systematically used in large locally advanced tumors&#46; There are no randomized trials or high level evidence due to its infrequency and the vast majority of the studies are retrospective studies with limited amount of patients&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">It has been seen that NACT is an effective therapy for tumor reduction in olfactory neuroblastomas&#44; allowing surgeons to achieve better surgical resection margins and reducing its complications&#46; An increase of OS and DFS between 70 and 90&#37; was observed in the latest series&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Complete endoscopic resection can be achieved in Kadish A&#44; B and resecable Kadish C tumors&#46; Although open approaches might be necessary for complete resection in more extensive neoplasms&#46; The tendency is to avoid open approaches and try to manage a fully endoscopic resection in order to minimize postoperative complications&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">We agree that more high level evidence is needed to unify concepts and develop treatment protocols for this rare kind of tumor&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflict of interest</span><p id="par0210" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1063362"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction and objectives"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusion"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1011598"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1063363"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introducci&#243;n y objetivos"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusi&#243;n"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1011599"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Materials and methods"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Patient data"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Treatment protocol"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Conclusion"
        ]
        9 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Conflict of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2017-03-28"
    "fechaAceptado" => "2017-07-17"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1011598"
          "palabras" => array:5 [
            0 => "Esthesioneuroblastoma"
            1 => "Olfactory neuroblastoma"
            2 => "Neoadjuvant chemotherapy"
            3 => "Endoscopic surgery"
            4 => "Adjuvant radiotherapy"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1011599"
          "palabras" => array:5 [
            0 => "Estesioneuroblastoma"
            1 => "Neuroblastoma olfatorio"
            2 => "Quimioterapia neoadyuvante"
            3 => "Resecci&#243;n endosc&#243;pica"
            4 => "Radioterapia adyuvante"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Olfactory neuroblastoma &#40;ONB&#41; is a rare entity that constitutes less than 5&#37; of nasosinusal malignancies&#46; Mainstream treatment consists in surgical resection<span class="elsevierStyleHsp" style=""></span>&#43;&#47;&#8722;<span class="elsevierStyleHsp" style=""></span>adjuvant radiotherapy&#46; By exposing results observed with apparition of new therapeutic options as neoadjuvant chemotherapy&#44; the objective is to evaluate a series and a review of the current literature&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective review was conducted including patients diagnosed and followed-up for ONB from 2008 to 2015 in our institution&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">9 patients were included&#46; Mean follow-up of 52&#46;5 months &#40;range 10&#8211;107&#41;&#46; Kadish stage&#58; A&#44; 1 patient &#40;11&#46;1&#37;&#41; treated with endoscopic surgery&#59; B&#44; 2 patients &#40;22&#46;2&#37;&#41; treated with endoscopic surgery &#40;one of them received adjuvant radiotherapy&#41;&#59; C&#44; 6 patients &#40;66&#46;7&#37;&#41;&#44; 4 patients presented intracranial extension and were treated with neoadjuvant chemotherapy followed by surgery and radiotherapy&#46; The other 2 patients presented isolated orbital extension&#44; treated with radical surgery &#40;endoscopic or craniofacial resection&#41; plus radiotherapy&#46; The 5-year disease free and overall survival observed was 88&#46;9&#37;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Neoadjuvant chemotherapy could be an effective treatment for tumor reduction&#44; improving surgical resection and reducing its complications&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction and objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusion"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Elneuroblastoma olfatorio es una entidad rara que se corresponde con menos del 5&#37; de las neoplasias nasosinusales&#46; El tratamiento principal consiste en la resecci&#243;n quir&#250;rgica<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>radioterapia adyuvante&#46; El objetivo es evaluar la sobrevida en una serie de casos y la literatura actual&#44; mostrando resultados observados con la aparici&#243;n de nuevas opciones terap&#233;uticas como la quimioterapia neoadyuvante&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio retrospectivo incluyendo pacientes tratados y seguidos en nuestro centro desde 2008 a 2015&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Dentro del estudio fueron incluidos 9 pacientes&#46; El seguimiento medio fue de 52&#44;5 meses &#40;rango 10-107&#41;&#46; Estadio Kadish&#58; A&#41; un paciente &#40;11&#44;1&#37;&#41; fue tratado con resecci&#243;n endosc&#243;pica&#59; B&#41; 2 pacientes &#40;22&#44;2&#37;&#41; tratados con resecci&#243;n endosc&#243;pica &#40;uno de ellos recibi&#243; radioterapia adyuvante&#41;&#59; C&#41; 6 pacientes &#40;66&#44;7&#37;&#41;&#44; de los cuales 4 presentaron extensi&#243;n intracraneal y fueron tratados con quimioterapia neoadyuvante&#44; cirug&#237;a y radioterapia adyuvante&#46; Los otros 2 pacientes presentaron invasi&#243;n intraorbitaria aislada&#44; tratados con cirug&#237;a radical y radioterapia adyuvante&#46; La sobrevida y periodo libre de enfermedad a 5 a&#241;os fue del 88&#44;9&#37;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La quimioterapia neoadyuvante puede ser un tratamiento efectivo para la reducci&#243;n del tama&#241;o tumoral&#44; mejorando la resecci&#243;n quir&#250;rgica y reduciendo sus complicaciones&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n y objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">The authors certify that they have no affiliations or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript&#46;</p>"
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1111
            "Ancho" => 1473
            "Tamanyo" => 133958
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Disease free survival&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1105
            "Ancho" => 1423
            "Tamanyo" => 127447
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Overall survival&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Stage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Confined to the nasal cavity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Involvement of one or more paranasal sinuses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Extension beyond the nasal cavity and paranasal sinuses involving cribriform lamina&#44; skull base&#44; orbit or intracranial cavity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">D&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Regional lymph node or distant metastasis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1812987.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Kadish staging system&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Stage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Tumor involving the nasal cavity and&#47;or paranasal sinuses &#40;excluding sphenoid&#41;&#44; sparing the most superior ethmoidal cells&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Tumor involving the nasal cavity and&#47;or paranasal sinuses &#40;including the sphenoid&#41; with extension to or erosion of the cribiform plate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Tumor extending into the orbit or protruding into the anterior cranial fossa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Tumor involving the brain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">N0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No cervical lymph node involvement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">N1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cervical lymph node metastasis present&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No distant metastases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Distant metastases present&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1812986.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Dulguerov staging system&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Stage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">N</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Hyams</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Kadish&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Low grade &#40;I-II&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">High grade &#40;III&#8211;IV&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">B</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;22&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">C</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;67&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>-Intracranial extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;44&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;75&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>-Orbital extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;67&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">D</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1812985.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Hyams grade&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">DF&#58; disease free&#46; NACT&#58; neoadjuvant chemotherapy&#46; ART&#58; adjuvant radiotherapy&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Kadish&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hyams&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NACT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Approach&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ART&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Follow-up &#40;months&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Endoscopic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive and DF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Endoscopic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive and DF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Endoscopic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive and DF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Orbit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Endoscopic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive and DF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">I&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Orbit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive and DF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive and DF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive and DF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive and DF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Orbit and IC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Craniofacial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dead of disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1812988.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Patient results&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:38 [
            0 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Neuroectodermal tumours"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:2 [
                        "titulo" => "Pathology and genetics of head and neck tumours"
                        "serieFecha" => "2005"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Esthesioneuroblastoma&#58; a population-based analysis of survival and prognostic factors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Jethanamest"
                            1 => "L&#46;G&#46; Morris"
                            2 => "A&#46;G&#46; Sikora"
                            3 => "D&#46;I&#46; Kutler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archotol.133.3.276"
                      "Revista" => array:5 [
                        "tituloSerie" => "Arch Otolaryngol Head Neck Surg"
                        "fecha" => "2007"
                        "volumen" => "133"
                        "paginaInicial" => "276"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17372086"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Esthesioneuroblastoma&#58; results and outcomes of a single institution&#39;s experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46;D&#46; Ward"
                            1 => "J&#46;A&#46; Heth"
                            2 => "B&#46;G&#46; Thompson"
                            3 => "L&#46;J&#46; Marentette"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0028-1096195"
                      "Revista" => array:5 [
                        "tituloSerie" => "Skull Base"
                        "fecha" => "2009"
                        "volumen" => "19"
                        "paginaInicial" => "133"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19721769"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Olfactory neuroblastoma&#58; the 22-year experience at one comprehensive cancer center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;M&#46; Diaz Jr&#46;"
                            1 => "R&#46;H&#46; Johnigan 3rd"
                            2 => "C&#46; Pero"
                            3 => "A&#46;K&#46; El-Naggar"
                            4 => "D&#46;B&#46; Roberts"
                            5 => "J&#46;L&#46; Barker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hed.20127"
                      "Revista" => array:6 [
                        "tituloSerie" => "Head Neck"
                        "fecha" => "2005"
                        "volumen" => "27"
                        "paginaInicial" => "138"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15654688"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1751991815000376"
                          "estado" => "S300"
                          "issn" => "17519918"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Esthesioneuroblastoma&#58; the Johns Hopkins experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "V&#46;A&#46; Resto"
                            1 => "D&#46;W&#46; Eisele"
                            2 => "A&#46; Forastiere"
                            3 => "M&#46; Zahurak"
                            4 => "D&#46;J&#46; Lee"
                            5 => "W&#46;H&#46; Westra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Head Neck"
                        "fecha" => "2000"
                        "volumen" => "22"
                        "paginaInicial" => "550"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10941155"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Esthesioneuroblastoma&#58; the Princess Margaret Hospital experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Bachar"
                            1 => "D&#46;P&#46; Goldstein"
                            2 => "M&#46; Shah"
                            3 => "A Tandon"
                            4 => "J&#46; Ringash"
                            5 => "G&#46; Pond"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hed.20920"
                      "Revista" => array:5 [
                        "tituloSerie" => "Head Neck"
                        "fecha" => "2008"
                        "volumen" => "30"
                        "paginaInicial" => "1607"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18798301"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Two cases of ectopic adrenocorticotropic hormone syndrome with olfactory neuroblastoma and literature review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;K&#46; Koo"
                            1 => "J&#46;H&#46; An"
                            2 => "K&#46;H&#46; Jeon"
                            3 => "S&#46;H&#46; Choi"
                            4 => "Y&#46;M&#46; Cho"
                            5 => "H&#46;C&#46; Jang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Endocr J"
                        "fecha" => "2008"
                        "volumen" => "55"
                        "paginaInicial" => "469"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18469486"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Olfactory neuroblastoma&#46; A clinical analysis of 17 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Kadish"
                            1 => "M&#46; Goodman"
                            2 => "C&#46;C&#46; Wang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "1976"
                        "volumen" => "37"
                        "paginaInicial" => "1571"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1260676"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Computed tomography and magnetic resonance imaging features of olfactory neuroblastoma&#58; an analysis of 22 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Pickuth"
                            1 => "S&#46;H&#46; Heywang-K&#246;brunner"
                            2 => "R&#46;P&#46; Spielmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Otolaryngol Allied Sci"
                        "fecha" => "1999"
                        "volumen" => "24"
                        "paginaInicial" => "457"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10542931"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0168822715002557"
                          "estado" => "S300"
                          "issn" => "01688227"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MRI of esthesioneuroblastoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46;P&#46; Derdeyn"
                            1 => "C&#46;J&#46; Moran"
                            2 => "F&#46;J&#46; Wippold 2nd&#46;"
                            3 => "D&#46;P&#46; Chason"
                            4 => "M&#46;B&#46; Koby"
                            5 => "F&#46; Rodriguez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Comput Assist Tomogr"
                        "fecha" => "1994"
                        "volumen" => "18"
                        "paginaInicial" => "16"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8282874"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Imaging of olfactory neuroblastoma &#8211; an analysis of 17 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46;J&#46; Kairemo"
                            1 => "A&#46;P&#46; Jekunen"
                            2 => "M&#46;S&#46; Kestil&#228;"
                            3 => "H&#46;A&#46; Ramsay"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Auris Nasus Larynx"
                        "fecha" => "1998"
                        "volumen" => "25"
                        "paginaInicial" => "173"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9673731"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The added value of 18F-FDG PET&#47;CT for evaluation of patients with esthesioneuroblastoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;M&#46; Broski"
                            1 => "C&#46;H&#46; Hunt"
                            2 => "G&#46;B&#46; Johnson"
                            3 => "R&#46;M&#46; Subramaniam"
                            4 => "P&#46;J&#46; Peller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2967/jnumed.112.102897"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Nucl Med"
                        "fecha" => "2012"
                        "volumen" => "53"
                        "paginaInicial" => "1200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22728262"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term follow-up using 18F-FDG PET&#47;CT for postoperative olfactory neuroblastoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Fujioka"
                            1 => "A&#46; Toriihara"
                            2 => "K&#46; Kubota"
                            3 => "Y&#46; Machida"
                            4 => "S&#46; Nakamura"
                            5 => "S&#46; Kishimoto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MNM.0000000000000135"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nucl Med Commun"
                        "fecha" => "2014"
                        "volumen" => "35"
                        "paginaInicial" => "857"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24751700"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0168822713003859"
                          "estado" => "S300"
                          "issn" => "01688227"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Esthesioneuroblastoma&#58; the University of Iowa experience 1978&#8211;1998"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;H&#46; Simon"
                            1 => "W&#46; Zhen"
                            2 => "T&#46;M&#46; McCulloch"
                            3 => "H&#46;T&#46; Hoffman"
                            4 => "A&#46;C&#46; Paulino"
                            5 => "N&#46;A&#46; Mayr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00005537-200103000-00020"
                      "Revista" => array:5 [
                        "tituloSerie" => "Laryngoscope"
                        "fecha" => "2001"
                        "volumen" => "111"
                        "paginaInicial" => "488"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11224781"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Esthesioneuroblastoma&#58; the massachusetts eye and ear infirmary and massachusetts general hospital experience with craniofacial resection&#44; proton beam radiation&#44; and chemotherapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;C&#46; Nichols"
                            1 => "A&#46;W&#46; Chan"
                            2 => "W&#46;T&#46; Curry"
                            3 => "F&#46;G&#46; Barker"
                            4 => "D&#46;G&#46; Deschler"
                            5 => "D&#46;T&#46; Lin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-2008-1076098"
                      "Revista" => array:5 [
                        "tituloSerie" => "Skull Base"
                        "fecha" => "2008"
                        "volumen" => "18"
                        "paginaInicial" => "327"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19240832"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radiotherapy alone for local tumour control in esthesioneuroblastoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Benfari"
                            1 => "M&#46; Fusconi"
                            2 => "A&#46; Ciofalo"
                            3 => "A&#46; Gallo"
                            4 => "G&#46; Altissimi"
                            5 => "T&#46; Celani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Otorhinolaryngol Ital"
                        "fecha" => "2008"
                        "volumen" => "28"
                        "paginaInicial" => "292"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19205593"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Combined endoscopic surgery and radiosurgery as treatment modality for olfactory neuroblastoma &#40;esthesioneuroblastoma&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46; Unger"
                            1 => "K&#46; Haselsberger"
                            2 => "C&#46; Walch"
                            3 => "H Stammberger"
                            4 => "G&#46; Papaefthymiou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "2005"
                        "volumen" => "147"
                        "paginaInicial" => "595"
                        "itemHostRev" => array:3 [
                          "pii" => "S0168822711002312"
                          "estado" => "S300"
                          "issn" => "01688227"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endoscopic endonasal resection of esthesioneuroblastoma&#58; a multicenter study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Folbe"
                            1 => "I&#46; Herzallah"
                            2 => "U&#46; Duvvuri"
                            3 => "M&#46; Bublik"
                            4 => "Z&#46; Sargi"
                            5 => "C&#46;H&#46; Snyderman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2500/ajra.2009.23.3269"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Rhinol Allergy"
                        "fecha" => "2009"
                        "volumen" => "23"
                        "paginaInicial" => "91"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19379620"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0033350617302111"
                          "estado" => "S300"
                          "issn" => "00333506"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endoscopic versus traditional craniofacial resection for patients with sinonasal tumors involving the anterior skull base"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;J&#46; Kim"
                            1 => "D&#46;W&#46; Kim"
                            2 => "S&#46;W&#46; Kim"
                            3 => "D&#46;H&#46; Han"
                            4 => "D&#46;-Y&#46; Kim"
                            5 => "C&#46;-S&#46; Rhee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3342/ceo.2008.1.3.148"
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Exp Otorhinolaryngol"
                        "fecha" => "2008"
                        "volumen" => "1"
                        "paginaInicial" => "148"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19434247"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endoscopic surgery for malignant tumors of the sinonasal tract and adjacent skull base&#58; a 10-year experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Nicolai"
                            1 => "P&#46; Battaglia"
                            2 => "M&#46; Bignami"
                            3 => "A&#46; Bolzoni Villaret"
                            4 => "G&#46; Del&#249;"
                            5 => "T&#46; Khrais"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2500/ajr.2008.22.3170"
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Rhinol"
                        "fecha" => "2008"
                        "volumen" => "22"
                        "paginaInicial" => "308"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18588765"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contemporary management of esthesioneuroblastoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;S&#46; Schwartz"
                            1 => "J&#46;N&#46; Palmer"
                            2 => "N&#46;D&#46; Adappa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MOO.0000000000000220"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Otolaryngol Head Neck Surg"
                        "fecha" => "2016"
                        "volumen" => "24"
                        "paginaInicial" => "63"
                        "paginaFinal" => "69"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26575517"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endoscopic management of esthesioneuroblastoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;R&#46; Roxbury"
                            1 => "M&#46; Ishii"
                            2 => "G&#46;L&#46; Gallia"
                            3 => "D&#46;D&#46; Reh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.otc.2015.09.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Otolaryngol Clin North Am"
                        "fecha" => "2016"
                        "volumen" => "49"
                        "paginaInicial" => "153"
                        "paginaFinal" => "165"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26614835"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neuroendocrine tumors of the sinonasal tract&#46; Results of a prospective study incorporating chemotherapy&#44; surgery&#44; and combined proton-photon radiotherapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;M&#46; Fitzek"
                            1 => "A&#46;F&#46; Thornton"
                            2 => "M&#46; Varvares"
                            3 => "M&#46; Ancukiewicz"
                            4 => "J&#46; Mcintyre"
                            5 => "J&#46; Adams"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "2002"
                        "volumen" => "94"
                        "paginaInicial" => "2623"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12173330"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multimodality therapy including radiotherapy and chemotherapy improves event-free survival in stage C esthesioneuroblastoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46;T&#46; Eich"
                            1 => "B&#46; Hero"
                            2 => "S&#46; Staar"
                            3 => "O&#46; Micke"
                            4 => "H&#46; Seegenschmiedt"
                            5 => "A&#46; Mattke"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00066-003-1089-x"
                      "Revista" => array:5 [
                        "tituloSerie" => "Strahlenther Onkol"
                        "fecha" => "2003"
                        "volumen" => "179"
                        "paginaInicial" => "233"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12707712"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Olfactory neuroblastoma&#58; the results of modern treatment approaches at the University of Michigan"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;J&#46; Zappia"
                            1 => "W&#46;R&#46; Carroll"
                            2 => "G&#46;T&#46; Wolf"
                            3 => "A&#46;F&#46; Thornton"
                            4 => "L&#46; Ho"
                            5 => "C&#46;J&#46; Krause"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Head Neck"
                        "fecha" => "1993"
                        "volumen" => "15"
                        "paginaInicial" => "190"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8491582"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Esthesioneuroblastoma&#58; continued follow-up of a single institution&#39;s experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;H&#46; Loy"
                            1 => "J&#46;F&#46; Reibel"
                            2 => "P&#46;W&#46; Read"
                            3 => "CY&#46; Thomas"
                            4 => "S&#46;A&#46; Newman"
                            5 => "J&#46;A&#46; Jane"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archotol.132.2.134"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Otolaryngol Head Neck Surg"
                        "fecha" => "2006"
                        "volumen" => "132"
                        "paginaInicial" => "134"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16490869"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0168822716301036"
                          "estado" => "S300"
                          "issn" => "01688227"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Esthesioneuroblastoma&#58; the Northwestern University experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Argiris"
                            1 => "J&#46; Dutra"
                            2 => "P&#46; Tseke"
                            3 => "K&#46; Haines"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00005537-200301000-00029"
                      "Revista" => array:5 [
                        "tituloSerie" => "Laryngoscope"
                        "fecha" => "2003"
                        "volumen" => "113"
                        "paginaInicial" => "155"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12514401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Combination chemotherapy &#40;cyclophosphamide&#44; doxorubicin&#44; and vincristine with continuous-infusion cisplatin and etoposide&#41; and radiotherapy with stem cell support can be beneficial for adolescents and adults with estheisoneuroblastoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Mishima"
                            1 => "E&#46; Nagasaki"
                            2 => "Y&#46; Terui"
                            3 => "T&#46; Irie"
                            4 => "S&#46; Takahashi"
                            5 => "Y&#46; Ito"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/cncr.20471"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "2004"
                        "volumen" => "101"
                        "paginaInicial" => "1437"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15368332"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of intracranial metastatic esthesioneuroblastoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;C&#46; Chamberlain"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/cncr.10679"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "2002"
                        "volumen" => "95"
                        "paginaInicial" => "243"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12124822"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neoadjuvant etoposide&#44; ifosfamide&#44; and cisplatin for the treatment of olfactory neuroblastoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;W&#46; Kim"
                            1 => "Y&#46;H&#46; Jo"
                            2 => "J&#46;H&#46; Kim"
                            3 => "H&#46;G&#46; Wu"
                            4 => "C&#46;S&#46; Rhee"
                            5 => "C&#46;H&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/cncr.20648"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "2004"
                        "volumen" => "101"
                        "paginaInicial" => "2257"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15484215"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Advanced adult esthesioneuroblastoma successfully treated with cisplatin and etoposide alternated with doxorubicin&#44; ifosfamide and vincristine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Turano"
                            1 => "C&#46; Mastroianni"
                            2 => "C&#46; Manfredi"
                            3 => "R&#46; Biamonte"
                            4 => "S&#46; Ceniti"
                            5 => "V&#46; Liguori"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11060-009-0052-9"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Neurooncol"
                        "fecha" => "2010"
                        "volumen" => "98"
                        "paginaInicial" => "131"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19924514"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "neoadjuvant chemotherapy in locally advanced and borderline resectable nonsquamous sinonasal tumors &#40;esthesioneuroblastoma and sinonasal tumor with neuroendocrine differentiation&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46;M&#46; Patil"
                            1 => "A&#46; Joshi"
                            2 => "V&#46; Noronha"
                            3 => "V&#46; Sharma"
                            4 => "S&#46; Zanwar"
                            5 => "S&#46; Dhumal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1155/2016/6923730"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Surg Oncol"
                        "fecha" => "2016"
                        "volumen" => "2016"
                        "paginaInicial" => "6923730"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26955484"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S2214999615012680"
                          "estado" => "S300"
                          "issn" => "22149996"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Esthesioneuroblastoma&#58; an update on the UCLA experience&#44; 2002&#8211;2013"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;A&#46; Tajudeen"
                            1 => "A&#46; Arshi"
                            2 => "J&#46;D&#46; Suh"
                            3 => "M&#46;F&#46; Palma-Diaz"
                            4 => "M&#46; Bergsneider"
                            5 => "E&#46; Abemayor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0034-1390011"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Neurol Surg B Skull Base"
                        "fecha" => "2015"
                        "volumen" => "76"
                        "paginaInicial" => "43"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25685649"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multidisciplinary treatment of olfactory neuroblastoma&#58; patterns of failure and management of recurrence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;J&#46; Petruzzelli"
                            1 => "J&#46;B&#46; Howell"
                            2 => "A&#46; Pederson"
                            3 => "T&#46;C&#46; Origitano"
                            4 => "R&#46;W&#46; Byrne"
                            5 => "L&#46; Munoz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjoto.2015.02.008"
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Otolaryngol"
                        "fecha" => "2015"
                        "volumen" => "36"
                        "paginaInicial" => "547"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25749259"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognostic utility of Hyams histological grading and Kadish-Morita staging systems for esthesioneuroblastoma outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Bell"
                            1 => "R&#46; Saade"
                            2 => "D&#46; Roberts"
                            3 => "T&#46;J&#46; Ow"
                            4 => "M&#46; Kupferman"
                            5 => "F&#46; DeMonte"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s12105-014-0547-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Head Neck Pathol"
                        "fecha" => "2015"
                        "volumen" => "9"
                        "paginaInicial" => "51"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24806334"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1751991817301109"
                          "estado" => "S300"
                          "issn" => "17519918"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Olfactory neuroblastoma&#58; a 35-year experience and suggested follow-up protocol"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Rimmer"
                            1 => "V&#46;J&#46; Lund"
                            2 => "T&#46; Beale"
                            3 => "W&#46;I&#46; Wei"
                            4 => "D&#46; Howard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/lary.24562"
                      "Revista" => array:6 [
                        "tituloSerie" => "Laryngoscope"
                        "fecha" => "2014"
                        "volumen" => "124"
                        "paginaInicial" => "1542"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24347437"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0168822714003088"
                          "estado" => "S300"
                          "issn" => "01688227"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endoscopic skull base surgery&#58; principles of endonasal oncological surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;H&#46; Snyderman"
                            1 => "R&#46;L&#46; Carrau"
                            2 => "A&#46;B&#46; Kassam"
                            3 => "A&#46; Zanation"
                            4 => "D&#46; Prevedello"
                            5 => "P&#46; Gardner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jso.21020"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Surg Oncol"
                        "fecha" => "2008"
                        "volumen" => "97"
                        "paginaInicial" => "658"
                        "paginaFinal" => "664"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18493946"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of esthesioneuroblastoma&#58; a 16-year meta-analysis of 361 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;K&#46; Devaiah"
                            1 => "M&#46;T&#46; Adfreoli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/lary.20280"
                      "Revista" => array:6 [
                        "tituloSerie" => "Laryngoscope"
                        "fecha" => "2009"
                        "volumen" => "119"
                        "paginaInicial" => "1412"
                        "paginaFinal" => "1416"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19444891"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735735/0000006900000004/v1_201807220439/S2173573518300553/v1_201807220439/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "5871"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735735/0000006900000004/v1_201807220439/S2173573518300553/v1_201807220439/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573518300553?idApp=UINPBA00004N"
]

Article information

ISSN: 21735735
Original language: English

DOI:10.1016/j.otoeng.2017.07.003

The statistics are updated each day

Year/Month	Html	Pdf	Total

2023 March	1	0	1
2021 March	0	4	4
2021 February	0	3	3
2021 January	0	5	5
2020 December	0	2	2
2020 November	0	2	2
2020 October	0	1	1
2020 September	0	2	2
2020 August	0	2	2
2020 June	0	2	2
2020 May	0	1	1
2020 April	0	1	1
2020 March	13	2	15
2020 February	13	2	15
2020 January	8	3	11
2019 December	23	7	30
2019 November	7	5	12
2019 October	8	2	10
2019 September	9	2	11
2019 August	8	3	11
2019 July	23	10	33

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter