Author(s)
Mark Arnold, MD
Mitchell R. Gore, MD, PhD
Affiliation(s)
SUNY Upstate Medical University
Abstract:
Introduction: To review the long-term outcomes and prognostic variables of patients treated for olfactory neuroblastoma (ONB) at a single institution.Methods: A retrospective review of all patients treated for ONB at a single institution over a 35-year period. Results: Eighteen patients were treated from 1980-2016. Nine out of 18 patients (50%) underwent endoscopic surgery, while 5 (28%) had craniofacial resection. Sixteen patients (89%) had radiotherapy, while 8 (44%) had chemotherapy. Twelve patients (66%) had adjuvant radiotherapy in addition to surgery. Four patients (20%) were managed non-surgically. The mean length of follow-up time was 5.2 years (range 0.33 -14.6 years). The 5-year overall survival was 61%, and the 5-year disease-free survival was 55%. Eight patients (44%) were alive without disease, one was alive with recurrence, seven died of disease, and one died of other causes. The mean time to local and regional recurrence was 3.38 years, with a range of 3 months to 7.75 years. Endoscopic versus craniofacial resection did not significantly affect survival. Dulguerov stage was predictive of disease-free survival (p=0.01), and margin status was predictive of both overall and disease-free survival (p=0.025, p=0.003).Conclusions: Endoscopic versus craniofacial resection for ONB did not significantly affect survival. Improved survival was associated with lower stage and negative surgical margins. The majority of patients were treated with multimodal treatment. Dulguerov stage best predicted disease free survival, and most patients recurred locally. Given the incidence of late recurrence, lifelong follow-up is essential.