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Clinical Outcomes and Multidisciplinary Patterns of Failure for Olfactory Neuroblastoma: The Ohio State Experience
Adam R Wolfe1, Dukagjin Blakaj1, Nyall London2
1Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States.
Abstract:
Purpose Olfactory neuroblastoma (ONB) is a rare head and neck cancer believed to be originated from neural crest cells of the olfactory membrane located in the roof of the nasal fossa. This study evaluates clinical outcomes and failure patterns in ONB patients of those patients treated with surgical resection at a high-volume tertiary cancer center. Methods and Materials Thirty-nine ONB patients who underwent surgical resection at our institution from 1996 to 2017 were retrospectively identified. Univariate, multivariate, and survival analysis were calculated using Cox regression analysis and Kaplan-Meier log-rank. Results Median follow-up time was 59 months (range: 5.2-236 months). The median overall survival (OS) and disease-free survival (DFS) for the entire cohort were 15 and 7.6 years, respectively. The 5-year cumulative OS and DFS were 83 and 72%, respectively. The 5-year OS for low Hyams grade (LHG) versus high Hyams grade (HHG) was 95 versus 61% ( p = 0.041). LHG was found in 66% of the early Kadish stage patients compared with 28% in the advanced Kadish stage patients ( p = 0.057). On multivariate analysis, HHG and positive node status predicted for worse OS and only HHG predicted for worse DFS. Of note, five patients (all Kadish stage A) who received surgical resection alone had no observed deaths or recurrences with a median follow-up of 44 months (range: 5-235 months). Conclusion In this retrospective cohort, patients with positive nodes or HHG have significantly worse clinical outcomes. Future studies should explore treatment intensification for HHG or positive nodes.
Insights
Olfactory neuroblastoma (ONB) outcomes are worse with high Hyams grade or positive nodes. Surgical resection alone may suffice for early-stage ONB patients, warranting further investigation for treatment intensification in high-risk cases.
Area of Science:
- Oncology
- Head and Neck Surgery
- Cancer Research
Background:
- Olfactory neuroblastoma (ONB) is a rare cancer originating from neural crest cells in the nasal fossa.
- Understanding clinical outcomes and failure patterns is crucial for optimizing treatment strategies.
Purpose of the Study:
- To evaluate clinical outcomes and failure patterns in olfactory neuroblastoma (ONB) patients treated with surgical resection.
- To identify prognostic factors influencing survival and disease-free survival in ONB.
Main Methods:
- Retrospective analysis of 39 ONB patients undergoing surgical resection between 1996 and 2017.
- Utilized Cox regression and Kaplan-Meier log-rank analysis for univariate, multivariate, and survival analyses.
Main Results:
- Median follow-up was 59 months; median overall survival (OS) and disease-free survival (DFS) were 15 and 7.6 years, respectively.
- Five-year OS and DFS were 83% and 72%. High Hyams grade (HHG) and positive nodes predicted worse OS; HHG predicted worse DFS.
- Early Kadish stage patients were more likely to have low Hyams grade (LHG). Five Kadish stage A patients treated with surgery alone showed no recurrence or death.
Conclusions:
- Positive nodes and HHG are significant predictors of worse clinical outcomes in ONB patients.
- Surgical resection alone may be effective for early-stage (Kadish stage A) ONB.
- Further research is needed to explore intensified treatment for HHG or node-positive ONB.
