Long-Term Outcome of Esthesioneuroblastoma: Hyams Grade Predicts Patient Survival

Abstract Object Esthesioneuroblastoma (ENB) is a rare malignant neuroendocrine tumor originating from the olfactory neuroepithelium in the cribriform plate. Controversy still exists regarding the role of pathologic grading (Hyams grade) in prognostication. This study was undertaken to describe our experience with ENB and assess the role of pathologic grading in patient outcome. Methods This was a retrospective, single-institution experience, including 109 patients with ENB treated at our institution from 1962 to 2009. Multivariate analysis was performed utilizing Cox regression analysis models utilizing age, gender, modified Kadish stage, and Hyams grade. Results Mean age was 49 ± 16 (median 50) years at presentation (range 12 to 90 years). Median follow up was 5.1 years. All-cause mortality was significantly influenced by Hyams grading in univariate (p = 0.04) and multivariate (p = 0.02) analysis, in addition to proven prognostic factors, Kadish staging, lymph node metastasis, and age. Median survival was 9.8 years compared with 6.9 years with low (grade 1 to 2) versus high (grade 3 to 4) Hyams grade. Median overall survival was 7.2 ± 0.7 years. Conclusion ENB has a variable outcome, which is primarily prognosticated by the extent of involvement at presentation (Kadish stage and lymph node metastasis) and higher Hyams pathologic grade.

[1]  M. Ozsahin,et al.  Outcome and prognostic factors in olfactory neuroblastoma: a rare cancer network study. , 2010, International journal of radiation oncology, biology, physics.

[2]  I. Barani,et al.  Posttreatment prognosis of patients with esthesioneuroblastoma. , 2010, Journal of neurosurgery.

[3]  C. Snyderman,et al.  New developments in transnasal endoscopic surgery for malignancies of the sinonasal tract and adjacent skull base , 2010, Current opinion in otolaryngology & head and neck surgery.

[4]  P. Theodosopoulos,et al.  Anterior skull base surgery: open versus endoscopic , 2009, Current opinion in otolaryngology & head and neck surgery.

[5]  D. Kutler,et al.  Esthesioneuroblastoma: a population-based analysis of survival and prognostic factors. , 2007, Archives of otolaryngology--head & neck surgery.

[6]  P. Levine,et al.  Esthesioneuroblastoma: continued follow-up of a single institution's experience. , 2006, Archives of otolaryngology--head & neck surgery.

[7]  H. Stammberger,et al.  Combined endoscopic surgery and radiosurgery as treatment modality for olfactory neuroblastoma (esthesioneuroblastoma) , 2005, Acta Neurochirurgica.

[8]  J. Chi,et al.  Olfactory Neuroblastomas: Survival Rate and Prognostic Factor , 2002, Journal of Neuro-Oncology.

[9]  F. Dias,et al.  Patterns of failure and outcome in esthesioneuroblastoma. , 2003, Archives of otolaryngology--head & neck surgery.

[10]  V. Lund,et al.  Olfactory Neuroblastoma: Past, Present, and Future? , 2003, The Laryngoscope.

[11]  H. Sand Hansen,et al.  Esthesioneuroblastoma: a Danish demographic study of 40 patients registered between 1978 and 2000. , 2003, Acta oto-laryngologica.

[12]  C. Buchwald,et al.  Esthesioneuroblastoma: A Danish clinicopathological study of 40 consecutive cases , 2002, APMIS : acta pathologica, microbiologica, et immunologica Scandinavica.

[13]  J. Mchugh,et al.  Esthesioneuroblastoma , 2001, Head & neck.

[14]  T. Calcaterra,et al.  Esthesioneuroblastoma: a meta-analysis and review. , 2001, The Lancet. Oncology.

[15]  K. Chao,et al.  Esthesioneuroblastoma: The impact of treatment modality , 2001, Head & neck.

[16]  H. Stammberger,et al.  Olfactory Neuroblastoma (Esthesioneuroblastoma): Report of Six Cases Treated by a Novel Combination of Endoscopic Surgery and Radiosurgery , 2001, Minimally invasive neurosurgery : MIN.

[17]  J. Gluckman,et al.  Esthesioneuroblastoma and Sinonasal Undifferentiated Carcinoma: Impact of Histological Grading and Clinical Staging on Survival and Prognosis , 2000, The Laryngoscope.

[18]  K. Olsen,et al.  Factors affecting survival of patients with tumors of the anterior skull base , 1994, The Laryngoscope.

[19]  K. Olsen,et al.  Esthesioneuroblastoma: prognosis and management. , 1993, Neurosurgery.

[20]  J. A. Ferguson,et al.  Esthesioneuroblastoma: the role of adjuvant radiation therapy. , 1993, International journal of radiation oncology, biology, physics.

[21]  T. Calcaterra,et al.  Esthesioneuroblastoma: The UCLA experience 1970–1990 , 1992, The Laryngoscope.

[22]  W. Lawson,et al.  Esthesioneuroblastoma: Surgical treatment without radiation , 1990, The Laryngoscope.

[23]  J. Batsakis,et al.  Tumors of the upper respiratory tract and ear , 1988 .

[24]  M. Homzie,et al.  Olfactory esthesioneuroblastoma—variables predictive of tumor control and recurrence , 1980, Cancer.

[25]  C. C. Wang,et al.  Olfactory neuroblastoma—A clinical analysis of 17 cases , 1976, Cancer.