Carotid body paragangliomas: a systematic study on management with surgery and radiotherapy
Tóm tắt
The definitive universally accepted treatment for carotid body tumors (CBT) is surgery. The impact of surgery on cranial nerves and the carotid artery has often been underestimated. Alternatively, a few CBTs have been followed without treatment or irradiation. The goal of this study is to summarize the existing evidence concerning the efficacy and safety of surgery and external beam radiotherapy (EBRT) for CBT. Relevant articles were identified using strict criteria for systematic searches. Sixty-seven articles met the criteria which included 2,175 surgically treated patients. On the other hand, 17 articles including 127 patients treated with EBRT were found. Long-term control of the disease was obtained in 93.8 % of patients who received surgical treatment and in 94.5 % of the radiotherapy group. Surgery resulted in 483 (483/2,175 = 22.2 %) new cranial nerve permanent deficits, whereas in the EBRT group, no new deficits were recorded (p = 0.004). The common/internal carotid artery was resected in 271 (12.5 %) patients because of injury or tumor encasement, with immediate reconstruction in 212 (9.7 %) patients. Three percent (60) of patients developed a permanent stroke and 1.3 % (26) died due to postoperative complications. The major complications rates and the mortality after completion of the treatment also were significantly higher in surgical series compared to EBRT series. This systematic analysis highlights evidence that EBRT offers a similar chance of tumor control with lower risk of morbidity as compared to surgery in patients with CBT. This questions the traditional notion that surgery should be the mainstay of treatment.
Tài liệu tham khảo
Kollert M, Minovi AA, Draf W, Bockmühl U (2006) Cervical paragangliomas-tumor control and long-term functional results after surgery. Skull Base 16:185–191
Atefi S, Nikeghbalian S, Yarmohammadi H, Assadi-Sabet A (2006) Surgical management of carotid body tumours: a 24-year surgical experience. ANZ J Surg 76:214–217
Rodriguez-Cuevas H, Lau I, Rodriguez HP (1986) High-altitude paragangliomas diagnostic and therapeutic considerations. Cancer 57:672–676
Bastounis E, Maltezos C, Pikoulis E, Leppaniemi AK, Klonaris C, Papalambros E (1999) Surgical treatment of carotid body tumours. Eur J Surg 165:198–202
van der Bogt KE, Vrancken Peeters MP, van Baalen JM, Hamming JF (2008) Resection of carotid body tumors: results of an evolving surgical technique. Ann Surg 247:877–884
Dalainas I, Nano G, Casana R, Bianchi P, Stegher S, Malacrida G, Tealdi DG (2006) Carotid body tumours. A 20-year single-institution experience. Chir Ital 58:631–635
Dardik A, Eisele DW, Williams GM, Perler PA (2002) A contemporary assessment of carotid body tumor surgery. Vasc Endovasc Surg 36:277–283
Davidovic L, Ilic N, Dimitrijevic M, Dukic V, Dzodic R (2008) Surgical management of cervical paragangliomas. Am Surg 74:1171–1176
Fruhwirth J, Koch G, Hauser H, Gutschi S, Beham A, Kainz J (1996) Paragangliomas of the carotid bifurcation: oncological aspects of vascularsurgery. Eur J Surg Oncol 22:88–92
Kasper GC, Welling RE, Wladis AR, CaJacob DE, Grisham AD, Tomsick TA, Gluckman JL, Muck PE (2007) A multidisciplinary approach to carotid paragangliomas. Vasc Endovasc Surg 40:467–474
Köhler HF, Carvalho AL, Mattos Granja NV, Nishinari K, Kowalski LP (2004) Surgical treatment of paragangliomas of the carotid bifurcation: results of 36 patients. Head Neck 26:1058–1063
Luna-Ortiz K, Rascon-Ortiz M, Villavicencio-Valencia V, Granados-Garcia M, Herrera-Gomez A (2005) Carotid body tumors: review of a 20-year experience. Oral Oncol 41:56–61
Koskas F, Vignes S, Khalil I, Koskas I, Dziekiewicz M, Elmkies F, Lamas G, Kieffer E (2009) Carotid chemodectomas: long-term results of subadventitial resection with deliberate external carotid resection. Ann Vasc Surg 23:67–75
Kotelis D, Rizos T, Geisbüsch P, Attigah N, Ringleb P, Hacke W, Allenberg JR, Böckler D (2009) Late outcome after surgical management of carotid body tumors from a 20-year single-center experience. Langenbecks Arch Surg 394:339–344
Kruger AJ, Walker PJ, Foster WJ, Jenkins JS, Boyne NS, Jenkins J (2010) Important observations made managing carotid body tumors during a 25-year experience. J Vasc Surg 52:1518–1523
Leonetti JP, Donzelli JJ, Littooy FN, Farrell BP (1997) Perioperative strategies in the management of carotid body tumors. Otolaryngol Head Neck Surg 117:111–115
Ma D, Liu L, Yao H, Hu Y, Ji T, Liu X, Zhang C, Qiu W (2009) A retrospective study in management of carotid body tumour. Br J Oral Maxillofac Surg 47:461–465
Makeieff M, Raingeard I, Alric P, Bonafe A, Guerrier B, Marty-Ane Ch (2008) Surgical management of carotid body tumors. Ann Surg Oncol 15:2180–2186
Marchesi M, Biffoni M, Nobili-Benedetti R, Jaus MO, Tartaglia F, De Antoni E, D’Andrea V, Biancari F, Campana FP (1997) Surgical treatment of paragangliomas of the neck. Int Surg 82:394–397
Muhm M, Polterauer P, Gstöttner W, Temmel A, Richling B, Undt G, Niederle B, Staudacher M, Ehringer H (1997) Diagnostic and therapeutic approaches to carotid body tumors. Review of 24 patients. Arch Surg 132:279–284
Obholzer RJ, Hornigold R, Connor S, Gleeson MJ (2011) Classification and management of cervical paragangliomas. Ann R Coll Surg Engl 93:596–602
Ozay B, Kurc E, Orhan G, Yucel O, Senay S, Tasdemir M, Gorur A, Aka SA (2008) Surgery of carotid body tumour: 14 cases in 7 years. Acta Chir Belg 108:107–111
Papaspyrou K, Mann WJ, Amedee RG (2009) Management of head and neck paragangliomas: review of 120 patients. Head Neck 31:381–387
Liapis CD, Evangelidakis EL, Papavassiliou VG, Kakisis JD, Gougoulakis AG, Polyzos AK, Sechas MN, Gogas JG (2000) Role of malignancy and preoperative embolization in the management of carotid body tumors. World J Surg 24:1526–1530
Mitchell RO, Richardson JD, Lambert GE (1996) Characteristics, surgical management, and outcome in 17 carotid body tumors. Am Surg 62:1034–1037
Paris J, Facon F, Thomassin JM, Zanaret M (2006) Cervical paragangliomas: neurovascular surgical risk and therapeutic management. Eur Arch Otorhinolaryngol 263:860–865
Patetsios P, Gable DR, Garrett WV, Lamont JP, Kuhn JA, Shutze WP, Kourlis H, Grimsley B, Pearl GJ, Smith BL, Talkington CM, Thompson JE (2002) Management of carotid body paragangliomas and review of a 30-year experience. Ann Vasc Surg 16:331–338
Sevilla García MA, Llorente Pendás JL, Rodrigo Tapia JP, García Rostán G, Suárez Fente V, Coca Pelaz A, Suárez C (2007) Paragangliomas de cabeza y cuello: revisión de 89 casos en 73 pacientes. Acta Otorrinolaringol Esp 58:94–100
Persky MS, Setton A, Niimi Y, Hartman J, Frank D, Berenstein A (2002) Combined endovascular and surgical treatment of head and neck paragangliomas—a team approach. Head Neck 24:423–431
Plukker JT, Brongers EP, Vermey A, Krikke A, van den Dungen JJ (2001) Outcome of surgical treatment for carotid body paraganglioma. Br J Surg 88:1382–1386
Qin RF, Shi LF, Liu YP, Lei DL, Hu KJ, Feng XH, Nie X, Mao TQ (2009) Diagnosis and surgical treatment of carotid body tumors: 25 years’ experience in China. Int J Oral Maxillofac Surg 38:713–718
Rodríguez-Cuevas S, López-Garza J, Labastida-Almendaro S (1998) Carotid body tumors in inhabitants of altitudes higher than 2000 meters above sea level. Head Neck 20:374–378
Sajid MS, Hamilton G, Baker DM, Joint Vascular Research Group (2007) A multicenter review of carotid body tumour management. Eur J Vasc Endovasc Surg 34:127–130
Meyer FB, Sundt TM Jr, Pearson BW (1986) Carotid body tumors: a subject review and suggested surgical approach. J Neurosurg 64:377–385
Pacheco-Ojeda L, Durango E, Rodriquez C, Vivar N (1988) Carotid body tumors at high altitudes: Quito, Ecuador, 1987. World J Surg 12:856–860
Netterville JL, Reilly KM, Robertson D, Reiber ME, Armstrong WB, Childs P (1995) Carotid body tumors: a review of 30 patients with 46 tumors. Laryngoscope 105:115–126
Nora JD, Hallett JW Jr, O’Brien PC, Naessens JM, Cherry KJ Jr, Pairolero PC (1988) Surgical resection of carotid body tumors: long-term survival, recurrence, and metastasis. Mayo Clin Proc 63:348–352
van Asperen de Boer FR, Terpstra JL, Vink M (1981) Diagnosis, treatment and operative complications of carotid body tumours. Br J Surg 68:433–438
Anand VK, Alemar GO, Sanders TS (1995) Management of the internal carotid artery during carotid body tumor surgery. Laryngoscope 105:231–235
Dickinson PH, Griffin SM, Guy AJ, McNeill IF (1986) Carotid body tumour: 30 years experience. Br J Surg 73:14–16
McPherson GA, Halliday AW, Mansfield AO (1989) Carotid body tumours and other cervical paragangliomas: diagnosis and management in 25 patients. Br J Surg 76:33–36
Kraus DH, Sterman BM, Hakaim AG, Beven EG, Levine HL, Wood BG, Tucker HM (1990) Carotid body tumors. Arch Otolaryngol Head Neck Surg 116:1384–1387
Hodge KM, Byers RM, Peters LJ (1988) Paragangliomas of the head and neck. Arch Otolaryngol Head Neck Surg 114:872–877
Williams MD, Phillips MJ, Nelson WR, Rainer WG (1992) Carotid body tumor. Arch Surg 127:963–967
Rosen IB, Palmer JA, Goldberg M, Mustard RA (1981) Vascular problems associated with carotid body tumors. Am J Surg 142:459–463
Lees CD, Levine HL, Beven EG, Tucker HM (1981) Tumors of the carotid body. Experience with 41 operative cases. Am J Surg 142:362–365
Padberg FT Jr, Cady D, Persson AV (1983) Carotid body tumor. The Lahey clinic experience. Am J Surg 145:526–528
Powell S, Peters N, Harmer C (1992) Chemodectoma of the head and neck: results of treatment in 84 patients. Int J Radiat Oncol Biol Phys 22:919–924
Elshaikh MA, Mahmoud-Ahmed AS, Kinney SE, Wood BG, Lee JH, Barnett GH, Suh JH (2002) Recurrent head-and-neck chemodectomas: a comparison of surgical and radiotherapeutic results. Int J Radiat Oncol Biol Phys 52:953–956
Smith JJ, Passman MA, Dattilo JB, Guzman RJ, Naslund TC, Netterville JL (2006) Carotid body tumor resection: does the need for vascular reconstruction worsen outcome? Ann Vasc Surg 20:435–439
Wang SJ, Wang MB, Barauskas TM, Calcaterra TC (2000) Surgical management of carotid body tumors. Otolaryngol Head Neck Surg 123:202–206
Bakoyiannis KC, Georgopoulos SE, Klonaris CN, Tsekouras NS, Felekouras ES, Pikoulis EA, Griniatsos JE, Papalambros EL, Bastounis EA (2006) Surgical treatment of carotid body tumors without embolization. Int Angiol 25:40–45
Daudi FA, Thurston OG (1989) Carotid body tumours: the University of Alberta Hospital experience. Can J Surg 32:159–161
Gaylis H, Davidge-Pitts K, Pantanowitz D (1987) Carotid body tumours. A review of 52 cases. S Afr Med J 72:493–496
Ghilardi G, Bortolani EM, Pizzocari P, Vandone PL, De Monti M (1991) Paragangliomi del collo. Analisi di 32 casi operati. Minerva Chir 46:1109–1117
Guerrier B, Makeieff M, Louche C, Mouketou JB, Crampette L (1995) Paragangliomes cervicaux. Resultats a propos d’une serie de 33 patients. J Chir (Paris) 132:287–294
Hallett JW Jr, Nora JD, Hollier LH, Cherry KJ Jr, Pairolero PC (1988) Trends in neurovascular complications of surgical management for carotid body and cervical paragangliomas: a fifty-year experience with 153 tumors. J Vasc Surg 7:284–291
LaMuraglia GM, Fabian RL, Brewster DC, Pile-Spellman J, Darling RC, Cambria RP, Abbott WM (1992) The current surgical management of carotid body paragangliomas. J Vasc Surg 15:1038–1044
Matticari S, Credi G, Pratesi C, Bertini D (1995) Diagnosis and surgical treatment of the carotid body tumors. J Cardiovasc Surg (Torino) 36:233–239
McCabe DP, Vaccaro PS, James AG (1990) Treatment of carotid body tumors. J Cardiovasc Surg (Torino) 31:356–358
Rabl H, Friehs I, Gutschi S, Pascher O, Koch G (1993) Diagnosis and treatment of carotid body tumors. Thorac Cardiovasc Surg 41:340–343
Reyt E, Guidicelli H, Mouret P, Tixier C, Junien-Lavillauroy C (1992) Paragangliomes branchiomeriques cervicaux. A propos de 21 cas. Ann Otolaryngol Chir Cervicofac 109:240–244
Sanghvi VD, Chandawarkar RY (1993) Carotid body tumors. J Surg Oncol 54:190–192
Thomassin JM, Zanaret M, Inedjian JM, Canale H, Cannoni M, Pech A (1989) Les paragangliomes lateraux cervicaux. Rev Laryngol Otol Rhinol (Bord) 110:213–217
Wax MK, Briant TD (1992) Carotid body tumors: a review. J Otolaryngol 21:277–285
Westerband A, Hunter GC, Cintora I, Coulthard SW, Hinni ML, Gentile AT, Devine J, Mills JL (1998) Current trends in the detection and management of carotid body tumors. J Vasc Surg 28:84–93
van der Mey AG, Frijns JH, Cornelisse CJ, Brons EN, van Dulken H, Terpstra HL, Schmidt PH (1992) Does intervention improve the natural course of glomus tumors? A series of 108 patients seen in a 32-year period. Ann Otol Rhinol Laryngol 101:635–642
Guedea F, Mendenhall WM, Parsons JT, Million RR (1991) Radiotherapy for chemodectoma of the carotid body and ganglion nodosum. Head Neck 13:509–513
Lybeert ML, van Andel JG, Eijkenboom WM, de Jong PC, Knegt P (1984) Radiotherapy of paragangliomas. Clin Otolaryngol Allied Sci 9:105–109
Hansen HS, Thomsen KA (1988) Radiotherapy in glomus tumours (paragangliomas). A 25 year-review. Acta Otolaryngol Suppl 449:151–154
Verniers DA, Keus RB, Schouwenburg PF, Bartelink H (1992) Radiation therapy, an important mode of treatment for head and neck chemodectomas. Eur J Cancer 28A:1028–1033
Bujko K, Kawecki A (1987) Radiotherapy of neck chemodectomas: long term results. Radiobiol Radiother (Berl) 28:749–753
Mitchell DC, Clyne CA (1985) Chemodectomas of the neck: the response to radiotherapy. Br J Surg 72:903–905
Krych AJ, Foote RL, Brown PD, Garces YI, Link MJ (2006) Long-term results of irradiation for paraganglioma. Int J Radiat Oncol Biol Phys 65:1063–1066
Schild SE, Foote RL, Buskirk SJ, Robinow JS, Bock FF, Cupps RE, Earle JD (1992) Results of radiotherapy for chemodectomas. Mayo Clin Proc 67:537–540
Sur RK, Krawitz HE, Malas S, Donde B, Levin CV (1995) Carotid body tumour–a case for radiotherapy? S Afr J Surg 33:106–108
Dinges S, Budach V, Stuschke M, Schmidt U, Budach W, Sack H (1993) Malignant paragangliomas—the results of radiotherapy in 6 patients. Strahlenther Onkol 169:114–120
Chino JP, Sampson JH, Tucci DL, Brizel DM, Kirkpatrick JP (2009) Paraganglioma of the head and neck: long-term local control with radiotherapy. Am J Clin Oncol 32:304–307
Hinerman RW, Amdur RJ, Morris CG, Kirwan J, Mendenhall WM (2008) Definitive radiotherapy in the management of paragangliomas arising in the head and neck: a 35-year experience. Head Neck 30:1431–1438
Valdagni R, Amichetti M (1990) Radiation therapy of carotid body tumors. Am J Clin Oncol 13:45–48
Shamblin WR, ReMine WH, Sheps SG, Harrison EG Jr (1971) Carotid body tumor (chemodectoma). Clinicopathologic analysis of ninety cases. Am J Surg 122:732–739
Jansen JC, van den Berg R, Kuiper A, van der Mey AG, Zwinderman AH, Cornelisse CJ (2000) Estimation of growth rate in patients with head and neck paragangliomas influences the treatment proposal. Cancer 88:2811–2816
Langerman A, Athavale SM, Rangarajan SV, Sinard RJ, Netterville JL (2012) Natural history of cervical paragangliomas: outcomes of observation of 43 patients. Arch Otolaryngol Head Neck Surg 138:341–345
Vogel TR, Mousa AY, Dombrovskiy VY, Haser PB, Graham AM (2009) Carotid body tumor surgery: management and outcomes in the nation. Vasc Endovasc Surg 43:457–461
Smith GL, Smith BD, Buchholz TA, Giordano SH, Garden AS, Woodward WA, Krumholz HM, Weber RS, Ang KK, Rosenthal DI (2008) Cerebrovascular disease risk in older head and neck cancer patients after radiotherapy. J Clin Oncol 26:5119–5125
Scott AS, Parr LA, Johnstone PA (2009) Risk of cerebrovascular events after neck and supraclavicular radiotherapy: a systematic review. Radiother Oncol 90:163–165
Haynes JC, Machtay M, Weber RS, Weinstein GS, Chalian AA, Rosenthal DI (2002) Relative risk of stroke in head and neck carcinoma patients treated with external cervical irradiation. Laryngoscope 112:1883–1887
Ruben JD, Davis S, Evans C, Jones P, Gagliardi F, Haynes M, Hunter A (2008) The effect of intensity-modulated radiotherapy on radiation-induced second malignancies. Int J Radiat Oncol Biol Phys 70:1530–1536
Cerecer-Gil NY, Figuera LE, Llamas FJ, Lara M, Escamilla JG, Ramos R, Estrada G, Hussain AK, Gaal J, Korpershoek E, de Krijger RR, Dinjens WN, Devilee P, Bayley JP (2010) Mutation of SDHB is a cause of hypoxia-related high-altitude paraganglioma. Clin Cancer Res 16:4148–4154
Grufferman S, Gillman MW, Pasternak LR, Peterson CL, Young WG Jr (1980) Familial carotid body tumors: case report and epidemiologic review. Cancer 46:2116–2122
Neumann HP, Erlic Z, Boedeker CC, Rybicki LA, Robledo M, Hermsen M, Schiavi F, Falcioni M, Kwok P, Bauters C, Lampe K, Fischer M, Edelman E, Benn DE, Robinson BG, Wiegand S, Rasp G, Stuck BA, Hoffmann MM, Sullivan M, Sevilla MA, Weiss MM, Peczkowska M, Kubaszek A, Pigny P, Ward RL, Learoyd D, Croxson M, Zabolotny D, Yaremchuk S, Draf W, Muresan M, Lorenz RR, Knipping S, Strohm M, Dyckhoff G, Matthias C, Reisch N, Preuss SF, Esser D, Walter MA, Kaftan H, Stöver T, Fottner C, Gorgulla H, Malekpour M, Zarandy MM, Schipper J, Brase C, Glien A, Kühnemund M, Koscielny S, Schwerdtfeger P, Välimäki M, Szyfter W, Finckh U, Zerres K, Cascon A, Opocher G, Ridder GJ, Januszewicz A, Suarez C, Eng C (2009) Clinical predictors for germ line mutations in head and neck paraganglioma patients: cost reduction strategy in genetic diagnostic process as fall-out. Cancer Res 69:3650–3656
Robertson D, Hollister AS, Biaggioni I, Netterville JL, Mosqueda-Garcia R, Robertson RM (1993) The diagnosis and treatment of baroreflex failure. N Engl J Med 329:1449–1455
Díaz Molina JP, Sevilla MA, Llorente Pendas JL, Suárez C (2010) Fallo barorreceptor tras la resección bilateral de paragangliomas carotídeos. Acta Otorrinolaringol Esp 61:78–80
De Toma G, Nicolanti V, Plocco M, Cavallaro G, Letizia C, Piccirillo G, Cavallaro A (2000) Baroreflex failure syndrome after bilateral excision of carotid body tumors: an underestimated problem. J Vasc Surg 31:806–810
Smit AA, Timmers HJ, Wieling W, Wagenaar M, Marres HA, Lenders JW, van Montfrans GA, Karemaker JM (2002) Long-term effects of carotid sinus denervation on arterial blood pressure in humans. Circulation 105:1329–1335
Timmers HJ, Karemaker JM, Wieling W, Marres HA, Folgering HT, Lenders JW (2003) Baroreflex and chemoreflex function after bilateral carotid body tumor resection. J Hypertens 21:591–599
Dahan A, Nieuwenhuijs D, Teppema L (2007) Plasticity of central chemoreceptors: effect of bilateral carotid body resection on central CO2 sensitivity. PLoS Med 4:e239
Pasini B, Stratakis CA (2009) SDH mutations in tumorigenesis and inherited endocrine tumours: lesson from the phaeochromocytoma-paraganglioma syndromes. J Intern Med 266:19–42
Druck NS, Spector GJ, Ciralsky RH, Ogura JH (1976) Malignant glomus vagale: report of a case and review of the literature. Arch Otolaryngol 102:534–536
Manolidis S, Shohet JA, Jackson CG, Glasscock ME 3rd (1999) Malignant glomus tumors. Laryngoscope 109:30–34
Lee JH, Barich F, Karnell LH, Robinson RA, Zhen WK, Gantz BJ, Hoffman HT (2002) National Cancer Data Base report on malignant paragangliomas of the head and neck. Cancer 94:730–737
Pacheco-Ojeda L (2001) Malignant carotid body tumors: report of three cases. Ann Otol Rhinol Laryngol 110:36–40
Arya S, Rao V, Juvekar S, Dcruz AK (2008) Carotid body tumors: objective criteria to predict the Shamblin group on MR imaging. AJNR Am J Neuroradiol 29:1349–1354
Hall FT, Perez-Ordonez B, Mackenzie RG, Gilbert RW (2003) Does catecholamine secretion from head and neck paragangliomas respond to radiotherapy? Case report and literature review. Skull Base 13:229–234
Suárez C, Rodrigo JP, Bödeker CC, Llorente JL, Silver CE, Jansen JC, Takes RP, Strojan P, Pellitteri PK, Rinaldo A, Mendenhall WM, Ferlito A (2012) Jugular and vagal paragangliomas: a systematic study on management with surgery and radiotherapy. Head Neck (Epub ahead of print)