Development of a Web-Based Nomogram for Predicting Survival in Patients with Esthesioneuroblastoma Using SEER...

Background: Esthesioneuroblastoma (ENB) is a rare neuroectodermal tumor arising from the olfactory epithelium. This study aimed to identify survival determinants and construct a prognostic web-based nomogram to provide individualized survival predictions for ENB patients. Methods: Patients diagnosed with ENB between 2000 and 2022 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Patient demographics, tumor characteristics, and treatment data were analyzed using Cox proportional hazards models and Kaplan-Meier survival curves. A web-based nomogram was constructed to predict 5- and 10-year survival probabilities individualized to a specific patient. Results: Nine hundred and forty-one ENB patients were analyzed. Overall survival (OS) rates at 1-, 2-, 5-, and 10-years were 89%, 85%, 75%, and 58%, respectively. Multivariable analysis revealed that age over 50 (p < 0.001) and tumor size over 6.0 cm (p < 0.01) were independent predictors of worse OS. Compared to patients treated with gross total resection (GTR) alone, worse OS was observed in those treated with chemotherapy (CT) only (p < 0.01), CT and radiation (RT, p < 0.01), GTR + CT (p < 0.05), RT only (p < 0.01), or no treatment (p < 0.001). No statistically significant differences in OS were found between GTR alone and GTR + RT, GTR + RT + CT, subtotal resection (STR), or STR with adjuvant therapies. The resulting ENB prognostic nomogram demonstrated acceptable predictive performance, with a C-index of 0.733 ± 0.041 and AUC of 0.749. Conclusions: Age and tumor size are critical survival determinants in ENB, and GTR continues to be the foundational treatment. The developed prognostic web-based nomogram successfully quantifies individualized survival probabilities, providing clinicians with a tailored tool to guide evidence-based counseling and management for ENB patients.