Abstract
Esthesioneuroblastoma (ENB) is derived from the specialized olfactory neuroepithelium. Hyams grading and Kadish staging have been used to prognosticate and to guide treatment decisions. In this study, we sought to validate the prognostic utility of these systems in a large ENB cohort. We retrospectively analyzed the records of patients with ENB who had been evaluated and treated at our institution. The association of grade and stage with prognostic outcome was assessed; the Kaplan–Meier estimator was used to generate 5-year OS and DFS curves. Out of 124 cases we identified, 121 were assessed for grading and 109 for staging. Review of the tissue samples revealed that 62 % of tumors were low grade (I/II) and 21 % were high grade (III/IV); 17 % of tumors were metastasis. The OS rate was 75 % at 5 years. The DFS was 60 % at 5 years. The OS was significantly worse for metastatic ENB (low-grade ENB vs metastatic ENB p = 0.01598); the DFS was significantly worse for high grade versus low grade ENB. Of the 109 cases that had been staged, 16 % were stage A, 33 % stage B, 43 % stage C, and 8 % stage D. In the A, B, and C groups, there were no significant differences between recurrence, distant metastasis, or 5-year survival rates. Statistical significance was not reached with the T, N, M and overall staging system. Age cutoff of 65 years reliably predicted OS. High grade of ENB was significantly associated with poor outcome, while advanced stage was not associated with poor outcome in this large cohort. Grading should certainly be considered in prognostication and treatment decisions for ENB.
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References
Bell D, Hanna EY. Sinonasal undifferentiated carcinoma: morphological heterogeneity, diagnosis, management and biological markers. Expert Rev Anticancer Ther. 2013;13:285–96.
Faragalla H, Weinreb I. Olfactory neuroblastoma: a review and update. Adv Anat Pathol. 2009;16:322–31.
Klepin HD, McMullen KP, Lesser GJ. Esthesioneuroblastoma. Curr Treat Options Oncol. 2005;6:509–18.
Ow TJ, Bell D, Kupferman ME, Demonte F, Hanna EY. Esthesioneuroblastoma. Neurosurg Clin N Am. 2013;24:51–65.
Platek ME, Merzianu M, Mashtare TL, et al. Improved survival following surgery and radiation therapy for olfactory neuroblastoma: analysis of the SEER database. Radiat Oncol. 2011;6:41.
Franssen EH, de Bree FM, Verhaagen J. Olfactory ensheathing glia: their contribution to primary olfactory nervous system regeneration and their regenerative potential following transplantation into the injured spinal cord. Brain Res Rev. 2007;56:236–58.
Holbrook EH, Wu E, Curry WT, Lin DT, Schwob JE. Immunohistochemical characterization of human olfactory tissue. The Laryngoscope. 2011;121:1687–701.
Uraih LC, Maronpot RR. Normal histology of the nasal cavity and application of special techniques. Environ Health Perspect. 1990;85:187–208.
Hyams VJ. Olfactory neuroblastoma (Case 6). In: Batsakis JG, Hyams VJ, Morales AR, editors. Special tumors of the head and neck. Chicago: ASCP Press; 1982. p. 24–9.
Kadish S, Goodman M, Wang CC. Olfactory neuroblastoma. A clinical analysis of 17 cases. Cancer. 1976;37:1571–6.
Morita A, Ebersold MJ, Olsen KD, Foote RL, Lewis JE, Quast LM. Esthesioneuroblastoma: prognosis and management. Neurosurgery 1993; 32:706–714; discussion 714–705.
Bachar G, Goldstein DP, Shah M, et al. Esthesioneuroblastoma: the Princess Margaret Hospital experience. Head Neck. 2008;30:1607–14.
Dulguerov P, Allal AS, Calcaterra TC. Esthesioneuroblastoma: a meta-analysis and review. Lancet Oncol. 2001;2:683–90.
Dulguerov P, Calcaterra T. Esthesioneuroblastoma: the UCLA experience 1970–1990. The Laryngoscope. 1992;102:843–9.
Zafereo ME, Fakhri S, Prayson R, et al. Esthesioneuroblastoma: 25-year experience at a single institution. Otolaryngol Head Neck Surg. 2008;138:452–8.
Jethanamest D, Morris LG, Sikora AG, Kutler DI. Esthesioneuroblastoma—a population-based analysis of survival and prognostic factors. Arch Otolaryngol Head Neck Surg. 2007;133:276–80.
Van Gompel JJ, Giannini C, Olsen KD, et al. Long-term outcome of esthesioneuroblastoma: hyams grade predicts patient survival. J Neurol Surg B Skull Base. 2012;73:331–6.
Bellizzi AM, Bourne TD, Mills SE, Stelow EB. The cytologic features of sinonasal undifferentiated carcinoma and olfactory neuroblastoma. Am J Clin Pathol. 2008;129:367–76.
Ejaz A, Wenig BM. Sinonasal undifferentiated carcinoma: clinical and pathologic features and a discussion on classification, cellular differentiation, and differential diagnosis. Adv Anat Pathol. 2005;12:134–43.
Iezzoni JC, Mills SE. “Undifferentiated” small round cell tumors of the sinonasal tract: differential diagnosis update. Am J Clin Pathol. 2005;124(Suppl):S110–21.
Malouf GG, Casiraghi O, Deutsch E, Guigay J, Temam S, Bourhis J. Low- and high-grade esthesioneuroblastomas display a distinct natural history and outcome. Eur J Cancer. 2013;49:1324–34.
Kaur G, Kane AJ, Sughrue ME, et al. The prognostic implications of Hyam’s subtype for patients with Kadish stage C esthesioneuroblastoma. J Clin Neurosci. 2013;20:281–6.
Weiss GJ, Liang WS, Izatt T, et al. Paired tumor and normal whole genome sequencing of metastatic olfactory neuroblastoma. PLoS ONE. 2012;7:e37029.
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This study was supported in part by MDACC start-up funds (DB). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or National Institutes of Health.
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Bell, D., Saade, R., Roberts, D. et al. Prognostic Utility of Hyams Histological Grading and Kadish-Morita Staging Systems for Esthesioneuroblastoma Outcomes. Head and Neck Pathol 9, 51–59 (2015). https://doi.org/10.1007/s12105-014-0547-3
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DOI: https://doi.org/10.1007/s12105-014-0547-3