Olfactory Neuroblastoma: Fate of the Neck--A Long-term Multicenter Retrospective Study

Area of Science:

• Oncology
• Head and Neck Surgery
• Pathology

Background:

• Olfactory neuroblastoma (ONB) presents unique challenges in managing neck disease.
• Understanding the incidence and risk factors for neck disease in ONB is crucial for effective patient management.

Purpose of the Study:

• To determine the incidence of neck disease in olfactory neuroblastoma.
• To identify factors influencing the development of neck disease.
• To identify patients at risk for cervical node-negative disease at presentation.

Main Methods:

• A multicenter case series with retrospective chart review.
• 113 patients with histologically confirmed olfactory neuroblastoma from 6 tertiary hospitals.
• Analysis of treatment modalities (surgery, radiotherapy, combined therapy) and long-term follow-up for disease-free survival.

Main Results:

• 7.1% of patients presented with primary neck disease, and 8.8% developed delayed neck disease.
• Higher histologic grades (Hyams II-IV) were observed in patients with neck disease.
• Positive surgical margins significantly increased the risk of delayed neck disease (17.9% vs 5%, P = .034).

Conclusions:

• Neck metastasis is a critical consideration in the presentation and surveillance of olfactory neuroblastoma.
• Primary treatment of the neck may be warranted for select patients.
• Long-term surveillance of both the neck and primary tumor site is essential for optimal outcomes.