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

Adam R. Wolfe, Dukagjin Blakaj, Nyall London, Adriana Blakaj, Brett Klamer, Jeff Pan, Paul Wakely, Luciano Prevedello, Marcelo Bonomi, Aashish Bhatt, Raju Raval, Joshua Palmer, Daniel Prevedello, Mauricio Gamez, Ricardo Carrau

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)287-294
Number of pages8
JournalJournal of Neurological Surgery, Part B: Skull Base
Volume81
Issue number3
DOIs
StatePublished - Jun 1 2020

Keywords

  • IMRT
  • olfactory neuroblastoma
  • radiation therapy

ASJC Scopus subject areas

  • Clinical Neurology

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    Wolfe, A. R., Blakaj, D., London, N., Blakaj, A., Klamer, B., Pan, J., Wakely, P., Prevedello, L., Bonomi, M., Bhatt, A., Raval, R., Palmer, J., Prevedello, D., Gamez, M., & Carrau, R. (2020). Clinical Outcomes and Multidisciplinary Patterns of Failure for Olfactory Neuroblastoma: The Ohio State Experience. Journal of Neurological Surgery, Part B: Skull Base, 81(3), 287-294. https://doi.org/10.1055/s-0039-1692479