Survival Associations between Patient Age and Treatment Modality in Olfactory Neuroblastoma: A Retrospective Population-Based Study

Burnham, Andre J.; Burnham, P. Alexander; Horwitz, Edwin M.

doi:10.3390/jcm10122685

Cited by 4 publications

(4 citation statements)

References 25 publications

(49 reference statements)

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“…This difference was significant in multivariate analysis as well. These findings are in concurrence with the findings of two large population database studies which brought out the detrimental effects of chemotherapy [ 8 , 30 ]. The poor outcomes for patients who received chemotherapy could be a reflection of the fact that the majority of the patients who were given chemotherapy had either Kadish C or D disease and most had unresectable disease or had difficult RT planning.…”

Section: Discussionsupporting

confidence: 89%

Treatment outcomes and prognostic factors of esthesioneuroblastoma— a retrospective study from South India

Nair¹,

Mathew²,

Rafi³

et al. 2023

ecancer

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Esthesioneuroblastoma (ENB) or olfactory neuroblastoma is a rare malignant neoplasm arising from the neural crest cells of the olfactory epithelium. The optimum treatment for this rare disease is still unclear. Most of the available literature on this rare head and neck tumour is limited to small retrospective series and single institutional reports. We conducted a retrospective study to investigate the clinical profile, treatment outcomes and prognostic factors of patients with ENB treated at a tertiary cancer centre in south India. Patients with a histopathological diagnosis of ENB treated from 2000 to 2019 were included. Patient demographics, tumour characteristics, stage, treatment details and outcome data were identified from medical records. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan–Meier method and the log-rank test was used for comparison. The prognostic factors were identified using Cox regression analysis. Forty-two patients underwent treatment for ENB from 2000 to 2019. Twenty-six patients underwent surgery. Twelve patients received radical radiotherapy (RT) while 24 patients underwent adjuvant radiation. After a median follow-up of 71 months, the estimated OS and DFS at 4 years were 64.4% and 54%, respectively. The estimated 4-year OS for modified Kadish A, B, C and D stages was 75.0%, 90.9%, 56.4% and 0%, respectively. Modified Kadish stage, nodal involvement, orbital invasion, intracranial extension, surgery, RT treatment and use of chemotherapy were significant predictors of OS and DFS in univariate Cox regression analysis. Orbital invasion and RT treatment were significant predictors of DFS in the multivariate analysis as well. However, only RT treatment came out to be a significant predictor for OS in multivariate Cox regression analysis. Surgery is the mainstay of treatment. Adjuvant RT may improve local control and survival in advanced cases. Advanced modified Kadish stage, lymph node involvement and orbital invasion are associated with poor outcomes.

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Section: Discussionsupporting

confidence: 89%

Treatment outcomes and prognostic factors of esthesioneuroblastoma— a retrospective study from South India

Nair¹,

Mathew²,

Rafi³

et al. 2023

ecancer

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“…44 One possible explanation for this result was that a great majority of patients with ONB who were treated with CT in the SEER database experienced distant metastases or underwent multimodality treatment, which might lead to an inferior CSS. 44 To date, there are few studies exploring the role of CT in patients with LA ONB. LA ONB exhibited a high propensity of invasion to adjacent organs and tissues; therefore, some previous studies have demonstrated that LT alone, including RT and/or SG, might not be sufficient to manage LA ONB.…”

Section: Discussionmentioning

confidence: 99%

“…A recent SEER database analysis of 882 patients with ONB showed that CT was associated with decreased cancer‐specific survival (CSS) 44 . One possible explanation for this result was that a great majority of patients with ONB who were treated with CT in the SEER database experienced distant metastases or underwent multimodality treatment, which might lead to an inferior CSS 44 . To date, there are few studies exploring the role of CT in patients with LA ONB.…”

Section: Discussionmentioning

confidence: 99%

Comparing the role of different treatment modalities in locoregionally advanced olfactory neuroblastoma: The 20‐year clinical experience of a single institution

et al. 2023

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Background The clinical value of different treatment modalities, especially systemic chemotherapy (CT) in patients with locoregionally advanced olfactory neuroblastoma (LA ONB) remains unclear. Methods Patients with LA ONB from 2000 to 2020 at our center were collected retrospectively. The entire cohort was divided into combined systemic and local therapy (CSLT) versus local therapy (LT) groups (grouping method 1), and the same cohort was divided into neoadjuvant chemotherapy (NAC) versus non‐NAC groups (grouping method 2). CSLT group included patients treated with CT + LT. LT group included patients treated with surgery (SG), radiotherapy (RT), concurrent chemoradiotherapy (CCRT), or any combination of the above methods. LT group was further divided into mono‐modality local therapy (MOLT) group and multi‐modality local therapy (MULT) group. MOLT group included patients treated with RT alone or SG alone. MULT group included patients treated with SG + RT/CCRT, or CCRT alone. NAC group included patients treated with NAC + LT ± adjuvant chemotherapy (ADC). Non‐NAC group included patients who received LT ± ADC. Results A total of 111 patients with LA ONB were included. The median follow‐up was 80.2 months (range, 2.1–254.9). The 5‐ and 10‐year OS rates were 70.2% and 61.3%, respectively. In univariate analysis, patients treated with NAC (n = 43) had significantly better overall survival (OS) compared with those without NAC (n = 68) (p = 0.041). Patients in MULT group (n = 45) had significantly improved OS (p = 0.004) and PFS (p = 0.003) compared with those in MOLT group (n = 15). Multivariate analysis identified NAC and CSLT (n = 51) were independent prognostic factors for superior OS (p = 0.020, p = 0.046). Conclusions Our study suggested that CSLT, especially a combination of NAC and LT, improved the survival of patients with LA ONB. Multiple treatment modalities yielded better PFS and OS compared to single‐modality treatment.

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“…The grade of ONB is classified according to Hyams and substantially affects prognosis [78][79][80]. Moreover, prognosis of ONB is negatively impacted by advanced age, male gender, locally advanced stage, nodal involvement, and positive margins [4,[81][82][83][84][85][86]. Classification of local extension is more controversial in contrast to the previously mentioned cancers.…”

Section: Olfactory Neuroblastomamentioning

confidence: 99%

Precision Medicine in the Treatment of Malignancies Involving the Ventral Skull Base: Present and Future

Ferrari

Taboni

Contro

et al. 2023

Critical Issues in Head and Neck Oncology

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Cancers involving the ventral skull base are rare and exceedingly heterogeneous. The variety of malignant tumors that arise in the nasal cavity, paranasal sinuses, nasopharynx, and adjacent mesenchymal tissues translates into a proportionally vast spectrum of prognoses, with some histologies such as olfactory neuroblastoma being associated with rare disease-specific death to other histologies such as mucosal melanoma for which survival beyond 5 years is considered a fortunate exception. Parallel to prognosis, treatment of sinonasal cancers is complex, controversial, and deeply dependent upon the putative pretreatment diagnosis. Given their heterogeneity, cancers of the ventral skull base are particularly prone to multidisciplinary management, which is indispensable. The therapeutic options available to date for these cancers include surgery, which currently remains the mainstay of treatment in most cases, along with radiotherapy and chemotherapy. Biotherapy and immunotherapy are only anecdotally and compassionately used. For each histology, a careful selection of modalities and their timing is paramount to ensure the best chance of cure. In keeping with the principles of precision medicine, several nuances displayed by malignancies of the ventral skull base are being considered as treatment-driving characteristics. This current trend arose from the observation that a remarkable variability of behavior can be observed even within a single histology. Although evidence is lacking in this field and several potential customizations of treatment are still at a theoretical level, understanding of these cancers is rapidly evolving and practical applications of this increasing knowledge is the much-needed step forward in the management of such rare cancers. This chapter highlights the tumor characteristics that may serve as treatment-driving factors in the most relevant cancers invading the ventral skull base.

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Survival Associations between Patient Age and Treatment Modality in Olfactory Neuroblastoma: A Retrospective Population-Based Study

Cited by 4 publications

References 25 publications

Treatment outcomes and prognostic factors of esthesioneuroblastoma— a retrospective study from South India

Treatment outcomes and prognostic factors of esthesioneuroblastoma— a retrospective study from South India

Comparing the role of different treatment modalities in locoregionally advanced olfactory neuroblastoma: The 20‐year clinical experience of a single institution

Precision Medicine in the Treatment of Malignancies Involving the Ventral Skull Base: Present and Future

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