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Radiographic predictors of occult intracranial involvement in olfactory neuroblastoma patients.
Geltzeiler, Mathew; Choby, Garret W; Ji, Keven Seung Yong; JessMace, C; Almeida, Joao Paulo; de Almeida, John; Champagne, Pierre-Olivier; Chan, Erik; Ciporen, Jeremy N; Chaskes, Mark B; Cornell, Sarah; Drozdowski, Veronica; Fernandez-Miranda, Juan; Gardner, Paul A; Hwang, Peter H; Kalyvas, Aristotelis; Kong, Keonho A; McMillan, Ryan A; Nayak, Jayakar V; Patel, Chirag; Patel, Zara M; Celda, Maria Peris; Pinheiro-Neto, Carlos; Sanusi, Olabisi R; Snyderman, Carl H; Thorp, Brian D; Van Gompel, Jamie J; Zadeh, Gelareh; Zenonos, Georgios; Zwagerman, Nathan T; Wang, Eric W.
Afiliação
  • Geltzeiler M; Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.
  • Choby GW; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Ji KSY; Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • JessMace C; Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.
  • Almeida JP; Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.
  • de Almeida J; Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA.
  • Champagne PO; Department of Surgery, University of Toronto, Ontario, Canada.
  • Chan E; Department of Neurological Surgery, Universite Laval, Quebec, Canada.
  • Ciporen JN; Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA.
  • Chaskes MB; Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA.
  • Cornell S; Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Drozdowski V; Department of Neurological Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
  • Fernandez-Miranda J; Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, USA.
  • Gardner PA; Department of Neurological Surgery, Stanford University, Palo Alto, California, USA.
  • Hwang PH; Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  • Kalyvas A; Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA.
  • Kong KA; Department of Surgery, University of Toronto, Ontario, Canada.
  • McMillan RA; Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Nayak JV; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Patel C; Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA.
  • Patel ZM; Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, USA.
  • Celda MP; Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA.
  • Pinheiro-Neto C; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Sanusi OR; Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Snyderman CH; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Thorp BD; Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Van Gompel JJ; Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA.
  • Zadeh G; Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  • Zenonos G; Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Zwagerman NT; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Wang EW; Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Int Forum Allergy Rhinol ; 13(10): 1876-1888, 2023 10.
Article em En | MEDLINE | ID: mdl-36841933
ABSTRACT

BACKGROUND:

Traditional management of olfactory neuroblastoma (ONB) includes margin-negative resection with removal of cribriform plate, dura, and olfactory bulb, regardless of intracranial disease. This approach may be overtreating certain patients. Our investigation examines risk factors associated with occult intracranial disease to optimize therapeutic outcomes.

METHODS:

This retrospective, multi-institutional cohort study examined clinical covariates associated with occult intracranial involvement. Patient demographics, staging, Hyam's grade, and pathologic involvement of dura, olfactory bulb/tract, and brain were collected. Diagnostic imaging was reviewed. Positive and negative predictive value (NPV) were estimated along with effect size estimates. Cox hazard regression examined associations with overall survival (OS) and disease-free survival (DFS).

RESULTS:

A total of 224 subjects with new diagnoses of ONB (2005-2021) were identified. Skull base bone involvement on computed tomography (CT) had the highest NPV for pathologic dura (88.0%), olfactory bulb (88%), and brain involvement (97.3%). Hyam's grade category was significantly associated with dural involvement (φC  = 0.26; 95% confidence interval [CI] 0.16, 0.42). Subjects without radiologic skull base involvement (n = 66) had pathologic positivity of 12.1%. Within this subgroup, Hyam's grade was clinically significant for dural positivity (φ = 0.34; 95% CI -0.12, 0.71) with 28.6% involvement in high grade tumors. Neither clinical nor pathologic positivity of intracranial structures were associated with significantly different OS or DFS.

CONCLUSIONS:

Both CT and magnetic resonance imaging (MRI) had reasonably good NPV for involvement of dura and olfactory bulb. Higher Hyam's grade was associated with dural involvement. Patients with low-grade tumors not involving the skull base may be suitable for avoiding skull base resection; however, further investigation is warranted.
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Texto completo: 1 Coleções: 01-internacional Temas: Geral / Tipos_de_cancer / Outros_tipos Base de dados: MEDLINE Assunto principal: Neoplasias Nasais / Estesioneuroblastoma Olfatório Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Int Forum Allergy Rhinol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Temas: Geral / Tipos_de_cancer / Outros_tipos Base de dados: MEDLINE Assunto principal: Neoplasias Nasais / Estesioneuroblastoma Olfatório Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Int Forum Allergy Rhinol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos