In Reply.—We appreciate the opinions expressed by Harrison. As he correctly observes, a large portion of our patients (actually, 46% of the series, rather than the 21% Harrison mentions in his letter) were afflicted with esthesioneuroblastoma, and in none of these cases did we remove the eye or have local recurrence. While we agree that esthesioneuroblastomas behave somewhat differently than other cancers, even if these are excluded from both series, Harrison removed the eye in 60 (27% ) of the 219 remaining patients, and we removed the eye in five (23%) of our remaining 22 patients. Obviously, our practices do not vary much.
There might be confusion regarding our use of the term frank invasion of the periorbita, but this was used to mean cancer invasion as determined by preirradiation therapy, computed tomographic, or magnetic resonance imaging scans. After radiation therapy, and at the time of surgical resection, if a