Unilateral Versus Bilateral Endoscopic Resection of Olfactory Neuroblastoma: Pooled Analysis From Prospective and Retrospective Multicenter Data.

IF 7.2 2区医学 Q1 OTORHINOLARYNGOLOGY International Forum of Allergy & Rhinology Pub Date : 2025-01-15 DOI:10.1002/alr.23531

Arash Abiri, Theodore V Nguyen, Haidee Chen, Elise Krippaehne, David K Lerner, Arifeen S Rahman, Pooya Roozdar, Brandon R Rosvall, Michael Sabbaj, Alan D Workman, Shannon Wu, Nithin D Adappa, Daniel M Beswick, Eugene H Chang, Michael T Chang, Garret Choby, Jacob G Eide, Jennifer E Douglas, Mathew Geltzeiler, Michael A Kohanski, Peter H Hwang, Christopher H Le, Jivianne T Lee, Jayakar V Nayak, James N Palmer, Zara M Patel, Carlos D Pinheiro-Neto, Adam C Resnick, Timothy L Smith, Carl H Snyderman, Maie A St John, Phillip B Storm, Jeffrey D Suh, Marilene B Wang, Eric W Wang, Edward C Kuan

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Abstract

Background: Olfactory neuroblastoma (ONB) is a rare sinonasal malignancy primarily treated with surgery. For tumors arising from the olfactory area, traditional treatment involves transcribriform resection of the anterior cranial fossa. Surgery can be performed with unilateral or bilateral resection depending on extent of involvement; however, there are currently no studies comparing outcomes between the two.

Methods: Prospective and retrospective data on primary ONB patients were collected from a multicenter registry involving eight academic sites. Propensity score matching (PSM) was used to create patient cohorts with similar baseline characteristics. Cox proportional hazards and Kaplan Meier analyses assessed overall survival (OS). Logistic regression assessed associations between extent of resection (unilateral versus bilateral) and tumor recurrence or postoperative cerebrospinal fluid (CSF) leak.

Results: A total of 187 ONB patients (47.6% female) with an average age of 53.6 ± 15.1 years were analyzed. Most tumors were unilateral (81.3%) and predominantly Kadish C (58.3%) or Hyams II (55.8%). Overall, 56.7% of patients underwent bilateral resection. Fifty-four patients experienced tumor recurrence and nine had postoperative CSF leaks. Following PSM (n = 45/group), extent of resection was not associated with mortality (hazard ratio [HR] 1.73; p = 0.407) or OS (p = 0.400). There was no association between extent of resection and recurrence (odds ratio [OR] 0.90; p = 0.814) or postoperative CSF leak (OR 1.54; p = 0.647).

Conclusions: For ONB tumors where unilateral resection may be feasible and oncologically sound, the decision for unilateral versus bilateral resection showed no significant effect on survival, recurrence, or postoperative CSF leak. Oncologic outcomes may be comparable when resection is tailored to individual patient and tumor characteristics.

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单侧与双侧嗅神经母细胞瘤内镜切除术：来自前瞻性和回顾性多中心数据的汇总分析。

背景：嗅觉神经母细胞瘤（ONB）是一种罕见的鼻腔恶性肿瘤，主要通过手术治疗。对于来自嗅觉区的肿瘤，传统的治疗方法包括对前颅窝进行转录切除。手术可根据受累程度进行单侧或双侧切除；然而，目前还没有研究比较这两者的结果。方法：从涉及8个学术站点的多中心注册中心收集原发性ONB患者的前瞻性和回顾性数据。倾向评分匹配（PSM）用于创建具有相似基线特征的患者队列。Cox比例风险和Kaplan Meier分析评估了总生存期（OS）。Logistic回归评估了切除程度（单侧与双侧）与肿瘤复发或术后脑脊液（CSF）泄漏之间的关系。结果：共分析ONB患者187例（女性47.6%），平均年龄53.6±15.1岁。大多数肿瘤为单侧（81.3%），以Kadish C型（58.3%）或Hyams II型（55.8%）为主。总体而言，56.7%的患者接受了双侧切除术。54例肿瘤复发，9例术后脑脊液渗漏。PSM术后（n = 45/组），切除程度与死亡率无关(危险比[HR] 1.73；p = 0.407)或OS （p = 0.400）。切除程度与复发无相关性(比值比[OR] 0.90；p = 0.814)或术后脑脊液泄漏(or 1.54；P = 0.647)。结论：对于单侧切除可行且肿瘤预后良好的ONB肿瘤，单侧或双侧切除的决定对生存、复发或术后脑脊液泄漏没有显著影响。当根据患者个体和肿瘤特征进行切除时，肿瘤预后可能具有可比性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Forum of Allergy & Rhinology OTORHINOLARYNGOLOGY-

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.