Posttreatment prognosis of patients with esthesioneuroblastoma

Ari J. Kane, Michael E. Sughrue, Martin J. Rutkowski, Derick Aranda, Steve A. Mills, Raphael Buencamino, Shanna Fang, Igor J. Barani, Andrew T. Parsa

Research output: Contribution to journalArticle

57 Scopus citations

Abstract

Object. There is no Class I evidence to guide the appropriate management of esthesioneuroblastoma (EN). Most data currently guiding treatment come from small- or modest-sized series gathered at individual centers that have concluded that surgery with radiotherapy is the preferred treatment. In this study, the authors summarize the published literature on treatment outcomes in patients with EN. The objective was to ascertain what variables predict prognosis in these patients and to determine the relative effect of different therapies. Methods. The authors identified 205 published studies containing treatment outcomes for surgery, radiotherapy, chemotherapy, or multimodal treatment. Using Kaplan-Meier analysis, the survival of patients who received surgery was compared with that in those who received surgery and radiotherapy. Additionally, Kadish staging was compared with low- and high-grade Hyams criteria to assess for subgroup prognostic significance in survival differences. Results. Nine hundred fifty-six patients met the inclusion criteria, with a median follow-up time of 3 years. Kaplan-Meier analysis demonstrated no difference in survival between patients who underwent surgery alone and those who underwent surgery plus radiotherapy at 5 years (78 vs 75%) or 10 years (67 vs 61%, respectively) (p = 0.3). Univariate analysis demonstrated worse survival in cases involving Kadish Grade C tumors, Hyams Grade 3 and 4 tumors, and in patients older than 65 years of age. Multivariate analysis demonstrated that Hyams Grade 3 and 4 lesions carried significant risk (proportional hazard = 4.83, p < 0.001) with 5- and 10-year survival of 47 and 31%. Conclusions. A biopsy should always be obtained in cases suspected of EN because histology is a strong prognostic indicator and will help guide appropriate treatment. Unimodal surgery and combined surgery/radiotherapy appear to be of equivalent efficacy with respect to survival in patients with EN. Chemotherapy should be considered in high-grade EN.

Original languageEnglish (US)
Pages (from-to)340-351
Number of pages12
JournalJournal of neurosurgery
Volume113
Issue number2
DOIs
StatePublished - Aug 1 2010
Externally publishedYes

Keywords

  • Esthesioneuroblastoma
  • Olfactory neuroblastoma
  • Prognosis
  • Radiation therapy
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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  • Cite this

    Kane, A. J., Sughrue, M. E., Rutkowski, M. J., Aranda, D., Mills, S. A., Buencamino, R., Fang, S., Barani, I. J., & Parsa, A. T. (2010). Posttreatment prognosis of patients with esthesioneuroblastoma. Journal of neurosurgery, 113(2), 340-351. https://doi.org/10.3171/2010.2.JNS091897