Pathologic dural invasion is associated with regional recurrence in olfactory neuroblastoma: A multi-institutional study.

IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY International Forum of Allergy & Rhinology Pub Date : 2024-11-13 DOI:10.1002/alr.23489
Anthony Tang, Suchet Taori, Nicholas Fung, Joao Paulo Almeida, Pierre-Olivier Champagne, Juan C Fernandez-Miranda, Paul Gardner, Peter H Hwang, Jayakar V Nayak, Chirag Patel, Zara M Patel, Maria Peris Celda, Carlos Pinheiro-Neto, Olabisi Sanusi, Carl Snyderman, Brian D Thorp, Jamie J Van Gompel, Georgios A Zenonos, Nathan T Zwagerman, Eric W Wang, Mathew Geltzeiler, Garret Choby
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Abstract

Objective: Neck metastases are a poor prognostic factor in olfactory neuroblastoma (ONB). Pathologic dural invasion (pathDI) may increase the risk of neck metastases due to invasion of dural lymphatics. We aim to evaluate the prognostic value of pathDI in predicting rates of neck metastases and recurrence using a large, multicenter database of ONB patients.

Data sources: Retrospective review of a prospective, multicenter database of electronic health records of all patients who presented with ONB between 2005 and 2021 at nine tertiary academic care centers within North America.

Review methods: Clinicopathologic features including modified Kadish staging systems, margin status, treatment modalities, Hyams grading, follow-up time, and survival.

Results: Of 258 ONB patients, 189 patients met the inclusion criteria. The 10-year neck recurrence-free survival (neck-RFS) rates were 85.7% (75.6‒97.3) and 61.8% (47.9‒79.8) for patients without and with pathDI, respectively (p = 0.018). Time-to-event multivariable regression analysis found pathDI to have an odds ratios of 9.7 (95% confidence interval [CI] 1.2-80.4, p = 0.04) for neck-RFS and 9.5 for RFS at any site (95% CI 1.1-83.3, p = 0.04).

Conclusion: In multivariable analysis, the presence of pathDI appears to be the strongest predictor of neck recurrence and recurrence at any site. Future studies exploring the benefit of elective neck dissection or radiation for patients with pathDI may impact disease management.

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病理硬膜侵犯与嗅觉神经母细胞瘤的区域复发有关:一项多机构研究。
目的:颈部转移是嗅觉神经母细胞瘤(ONB)的不良预后因素:颈部转移是嗅觉神经母细胞瘤(ONB)预后不良的一个因素。病理性硬膜侵犯(pathDI)可能会因硬膜淋巴管的侵犯而增加颈部转移的风险。我们的目的是利用一个大型多中心ONB患者数据库,评估病理性硬膜浸润在预测颈部转移率和复发率方面的预后价值:对北美九家三级学术护理中心 2005 年至 2021 年间所有 ONB 患者电子健康记录的前瞻性多中心数据库进行回顾性回顾:临床病理特征包括改良的凯迪什分期系统、边缘状态、治疗方式、海姆斯分级、随访时间和生存期:结果:在258例ONB患者中,189例符合纳入标准。无病理DI和有病理DI患者的10年颈部无复发生存率(neck-RFS)分别为85.7%(75.6-97.3)和61.8%(47.9-79.8)(p = 0.018)。时间到事件多变量回归分析发现,路径指示对颈部RFS的几率比为9.7(95% 置信区间[CI] 1.2-80.4,P = 0.04),对任何部位RFS的几率比为9.5(95% CI 1.1-83.3,P = 0.04):在多变量分析中,PathDI的存在似乎是颈部复发和任何部位复发的最强预测因素。未来的研究将探索选择性颈部切除术或放射治疗对病理DI患者的益处,这可能会对疾病管理产生影响。
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来源期刊
CiteScore
11.70
自引率
10.90%
发文量
185
审稿时长
6-12 weeks
期刊介绍: International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy. International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.
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