J Neurol Surg B
DOI: 10.1055/s-0039-1692479
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Clinical Outcomes and Multidisciplinary Patterns of Failure for Olfactory Neuroblastoma: The Ohio State Experience

1  Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
,
Dukagjin Blakaj*
1  Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
,
Nyall London
2  Department of Otolaryngology, The Ohio State University, Columbus, Ohio, United States
,
Adriana Blakaj
3  Department of Radiation Oncology, Yale University, New Haven, Connecticut, United States
,
Brett Klamer
4  Department of Biostatistics, The Ohio State University, Columbus, Ohio, United States
,
Jeff Pan
4  Department of Biostatistics, The Ohio State University, Columbus, Ohio, United States
,
Paul Wakely
5  Department of Pathology, The Ohio State University, Columbus, Ohio, United States
,
Luciana Prevedello
6  Department of Radiology, The Ohio State University, Columbus, Ohio, United States
,
Marcelo Bonomi
7  Department of Medical Oncology, The Ohio State University, Columbus, Ohio, United States
,
Aashish Bhatt
1  Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
,
Raju Raval
1  Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
,
Joshua Palmer
1  Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, United States
,
Daniel Prevedello
4  Department of Biostatistics, The Ohio State University, Columbus, Ohio, United States
,
Ricardo Carrau
2  Department of Otolaryngology, The Ohio State University, Columbus, Ohio, United States
› Author Affiliations
Further Information

Publication History

02 January 2019

08 May 2019

Publication Date:
12 June 2019 (online)

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.

* Co-first authors, contributed equally.