OBJECTIVETo investigate the optimal treatment strategy with endoscopic endonasal approach (EEA) and the prognostic factors of anterior and middle skull base neuroendocrine carcinoma (NEC).

METHODFourteen patients with anterior and/or middle skull base NEC, admitted to Xuanwu Hospital between November 2006 and June 2014, were reviewed retrospectively. All patients were treated with EEA. Four cases received surgery onle. Two cases received radiotherapy and one case received chemotherapy before surgery. One case received adjuvant radiotherapy and 6 cases received chemoradiation after surgery. Survival analysis was performed by Kaplan-Meier method.

RESULTComplete resection was achieved in 12 cases, while subtotal resection was achieved in 2 cases. There was no surgical complication. Three cases were diagnosed as well-differentiated NEC, 2 cases were moderately differentiated NEC and 9 cases were small cell NEC. The patients were followed up for 6 to 97 months. Three patients died and one patient lost to follow-up. The 5-year survival rate in this group was 64.3%.

CONCLUSIONPure EEA or EEA combined with multimodality therapy, which was applied depending on the pathological type, was a feasible treatment strategy for anterior and middle skull base NEC.