International forum of allergy & rhinology · 2026
Early Versus Late Recurrence in Olfactory Neuroblastoma: A Multi-Institutional Analysis of Predictive Risk Factors.
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Harris Alexandria, Tang Anthony, Fung Nicholas, Almeida Joao Paulo, Champagne Pierre-Olivier, Fernandez-Miranda Juan, Gardner Paul A, Hwang Peter, Kalyvas Aristotelis, Patel Chirag, Patel Zara M, Celda Maria Peris, Pinheiro-Neto Carlos D, Sanusi Olabisi, Snyderman Carl H, Thorp Brian D, Van Gompel Jamie J, Zenonos Georgios, Zwagerman Nathan T, Bell Diana, Kuan Edward C, Wang Eric W, Geltzeiler Mathew, Choby Garret
Аннотация
BACKGROUND: Olfactory neuroblastoma (ONB) exhibits variable recurrence patterns, with significant late recurrences occurring years after treatment. We investigated cutoff periods to define late recurrence and identified predictors that distinguish patients at risk of late recurrence from those considered cured.
METHODS: From a multi-institutional cohort of 219 ONB patients treated at nine centers, we analyzed 77 patients with documented recurrence. Using a 48-month cutoff to define early (< 48 months) versus late (≥ 48 months) recurrence, we evaluated 35 clinical, anatomic, and treatment variables using Firth penalized logistic regression across three comparisons: (1) late versus early recurrence timing, (2) late recurrence versus no recurrence, and (3) early recurrence versus no recurrence.
RESULTS: Thirty-four of the 77 (44.2%) recurrences were classified as late. Among the 77 patients who recurred, smaller tumor volume (OR 0.243, p = 0.035) and lower novel Dulguerov staging (OR 0.802, p = 0.038) were associated with late, rather than early recurrence. When patients with late recurrence were compared to those who remained disease-free, radiographic skull base bone involvement was the strongest independent predictor (OR 2.90, 95% CI 1.14-8.64, p = 0.025), and this effect strengthened after adjusting for tumor volume (OR 3.80, p = 0.029). Pathologic dural invasion (OR 3.29, p = 0.013), Kadish stage (OR 2.02, p = 0.026), and T-stage (OR 1.32, p = 0.040) were also significant.
CONCLUSIONS: A 48-month cutoff effectively stratifies ONB recurrence risk. Skull base bone involvement independently predicts recurrence when compared to nonrecurrent cases and uniquely persists as a risk factor for late recurrence. These findings establish skull base bone involvement as a novel biomarker for risk-stratified surveillance protocols.
METHODS: From a multi-institutional cohort of 219 ONB patients treated at nine centers, we analyzed 77 patients with documented recurrence. Using a 48-month cutoff to define early (< 48 months) versus late (≥ 48 months) recurrence, we evaluated 35 clinical, anatomic, and treatment variables using Firth penalized logistic regression across three comparisons: (1) late versus early recurrence timing, (2) late recurrence versus no recurrence, and (3) early recurrence versus no recurrence.
RESULTS: Thirty-four of the 77 (44.2%) recurrences were classified as late. Among the 77 patients who recurred, smaller tumor volume (OR 0.243, p = 0.035) and lower novel Dulguerov staging (OR 0.802, p = 0.038) were associated with late, rather than early recurrence. When patients with late recurrence were compared to those who remained disease-free, radiographic skull base bone involvement was the strongest independent predictor (OR 2.90, 95% CI 1.14-8.64, p = 0.025), and this effect strengthened after adjusting for tumor volume (OR 3.80, p = 0.029). Pathologic dural invasion (OR 3.29, p = 0.013), Kadish stage (OR 2.02, p = 0.026), and T-stage (OR 1.32, p = 0.040) were also significant.
CONCLUSIONS: A 48-month cutoff effectively stratifies ONB recurrence risk. Skull base bone involvement independently predicts recurrence when compared to nonrecurrent cases and uniquely persists as a risk factor for late recurrence. These findings establish skull base bone involvement as a novel biomarker for risk-stratified surveillance protocols.