Early Versus Late Recurrence in Olfactory Neuroblastoma: A Multi-Institutional Analysis of Predictive Risk Factors.

Area of Science:

• Oncology
• Neurosurgery
• Pathology

Background:

• Olfactory neuroblastoma (ONB) presents varied recurrence patterns, with a notable proportion of late recurrences occurring years post-treatment.
• Identifying reliable predictors for late recurrence is crucial for distinguishing patients who are cured from those at ongoing risk.

Purpose of the Study:

• To establish a cutoff period for defining late recurrence in olfactory neuroblastoma.
• To identify clinical, anatomic, and treatment-related predictors differentiating late versus early recurrence and recurrence versus no recurrence.

Main Methods:

• Analysis of a multi-institutional cohort of 219 ONB patients, focusing on 77 with documented recurrence.
• Utilized a 48-month cutoff to categorize recurrences as early (<48 months) or late (≥48 months).
• Employed Firth penalized logistic regression to evaluate 35 variables across three comparative analyses.

Main Results:

• 44.2% of recurrences (34/77) were classified as late.
• Smaller tumor volume and lower Dulguerov staging were associated with late recurrence.
• Skull base bone involvement was the strongest independent predictor of recurrence compared to disease-free patients, with its effect amplified after adjusting for tumor volume.

Conclusions:

• A 48-month cutoff effectively stratifies ONB recurrence risk.
• Skull base bone involvement is a significant independent predictor of recurrence and a unique risk factor for late recurrence.
• Skull base bone involvement serves as a novel biomarker for risk-stratified surveillance protocols in ONB management.