TY - JOUR
T1 - Olfactory neuroblastoma
T2 - fate of the neck - a long-term multicenter retrospective study
AU - Nalavenkata, Sunny B.
AU - Sacks, Raymond
AU - Adappa, Nithin D.
AU - Palmer, James N.
AU - Purkey, Michael T.
AU - Feldman, Michael D.
AU - Schlosser, Rodney J.
AU - Snyderman, Carl H.
AU - Wang, Eric W.
AU - Woodworth, Bradford A.
AU - Smee, Robert
AU - Havas, Thomas E.
AU - Gallagher, Richard
AU - Harvey, Richard J.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Objective: Olfactory neuroblastoma and the management of neck disease has posed considerable challenges to the treating physician. The aims of the study were to determine the incidence and factors influencing neck disease and to identify at-risk patients with cervical node-negative disease at presentation. Study Design: Multicenter case series with retrospective chart review. Setting and Subjects: In sum, 113 patients with a histopathologic diagnosis of olfactory neuroblastoma across 6 tertiary hospitals in Australia and the United States. Methods: Treatment modalities for the primary site and neck included surgery, radiotherapy, and combined therapy. Treatment outcomes were measured in relation to date of primary treatment, and long-term follow-up was recorded. Disease-free survival was calculated as time for patients to develop delayed neck disease following primary treatment. Results: A total of 113 patients (46 females, 49.7 ± 13.2 years) were identified with a median follow-up of 41.5 months (interquartile range, 58.2); 7.1% of patients presented with primary neck disease, while 8.8% of patients presented with delayed neck disease. Neck disease was present in patients with Hyams grade II (22.2%), III (55.6%), and IV (22.2%) lesions (χ2 = 5.66, P =.13). Histologic grade was higher in patients with primary neck disease (χ2 = 16.22, P =.001). Positive surgical margins were associated with a higher risk of delayed neck disease as compared with clear surgical margin (17.9% vs 5%, P =.034). Conclusion: Neck metastasis is an important clinical consideration for olfactory neuroblastoma at presentation and in surveillance. Primary treatment of the neck could be considered in select patients. Long-term surveillance of the neck and primary site is essential.
AB - Objective: Olfactory neuroblastoma and the management of neck disease has posed considerable challenges to the treating physician. The aims of the study were to determine the incidence and factors influencing neck disease and to identify at-risk patients with cervical node-negative disease at presentation. Study Design: Multicenter case series with retrospective chart review. Setting and Subjects: In sum, 113 patients with a histopathologic diagnosis of olfactory neuroblastoma across 6 tertiary hospitals in Australia and the United States. Methods: Treatment modalities for the primary site and neck included surgery, radiotherapy, and combined therapy. Treatment outcomes were measured in relation to date of primary treatment, and long-term follow-up was recorded. Disease-free survival was calculated as time for patients to develop delayed neck disease following primary treatment. Results: A total of 113 patients (46 females, 49.7 ± 13.2 years) were identified with a median follow-up of 41.5 months (interquartile range, 58.2); 7.1% of patients presented with primary neck disease, while 8.8% of patients presented with delayed neck disease. Neck disease was present in patients with Hyams grade II (22.2%), III (55.6%), and IV (22.2%) lesions (χ2 = 5.66, P =.13). Histologic grade was higher in patients with primary neck disease (χ2 = 16.22, P =.001). Positive surgical margins were associated with a higher risk of delayed neck disease as compared with clear surgical margin (17.9% vs 5%, P =.034). Conclusion: Neck metastasis is an important clinical consideration for olfactory neuroblastoma at presentation and in surveillance. Primary treatment of the neck could be considered in select patients. Long-term surveillance of the neck and primary site is essential.
KW - esthesioneuroblastoma
KW - lymphatic metastases
KW - endoscopy
KW - surgery
KW - radiotherapy
KW - neck
UR - http://www.scopus.com/inward/record.url?scp=84957590686&partnerID=8YFLogxK
U2 - 10.1177/0194599815620173
DO - 10.1177/0194599815620173
M3 - Article
C2 - 26671900
AN - SCOPUS:84957590686
SN - 0194-5998
VL - 154
SP - 383
EP - 389
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 2
ER -