Regional Recurrences and Hyams Grade in Esthesioneuroblastoma

Hedyeh Ziai; Eugene Yu; Ilan Weinreb; Bayardo Perez-Ordonez; Christopher M. K. L. Yao; Wei Xu; Dongyang Yang; Ian J. Witterick; Eric Monteiro; Ralph W. Gilbert; Jonathan C. Irish; Patrick J. Gullane; David P. Goldstein; Jolie Ringash; Andrew Bayley; John R. de Almeida

doi:10.1055/s-0040-1715809

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base 2021; 82(06): 608-614
DOI: 10.1055/s-0040-1715809

Original Article

Regional Recurrences and Hyams Grade in Esthesioneuroblastoma

Hedyeh Ziai

¹Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

,

Eugene Yu

²Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada

,

Ilan Weinreb

³Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada

,

Bayardo Perez-Ordonez

³Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada

,

Christopher M. K. L. Yao

¹Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

,

Wei Xu

⁴Department of Biostatistics, the Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada

,

Dongyang Yang

⁴Department of Biostatistics, the Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada

,

Ian J. Witterick

¹Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

,

Eric Monteiro

¹Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

,

Ralph W. Gilbert

¹Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

,

Jonathan C. Irish

¹Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

,

Patrick J. Gullane

¹Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

,

David P. Goldstein

¹Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

,

Jolie Ringash

⁵Department of Radiation Oncology, the Princess Margaret Cancer Centre, Toronto, Ontario, Canada

,

Andrew Bayley

⁵Department of Radiation Oncology, the Princess Margaret Cancer Centre, Toronto, Ontario, Canada

,

John R. de Almeida

¹Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

› Author Affiliations

Abstract

Objective The aim of this study is to determine if Hyams grade may help predict which patients with esthesioneuroblastoma (ENB) tumors are likely to develop regional recurrences, and to determine the impact of tumor extent on regional failure in ENB patients without evidence of nodal disease at presentation.

Design The study was designed as a retrospective review for ENB patients.

Settings The study was prepared at tertiary care academic center for ENB patients.

Participants Patients with ENB were included in the study.

Main Outcome Measures Oncologic outcomes (5-year regional and locoregional control (LRC) and overall survival) in patients with Hyams low grade versus high grade. Oncologic outcomes based on radiographic disease extent.

Results A total of 43 patients were included. Total 25 patients (58%) had Hyams low-grade tumor, and 18 (42%) had high-grade tumor. Of the 34 patients without regional disease at presentation, 8 (24%) were treated with elective nodal radiation. There were no statistically significant differences in 5-year regional control in the Hyams low-grade versus high-grade groups (78 vs. 89%; p = 0.4). The 5-year LRC rates in patients with low grade versus high grade were 73 versus 89% (p = 0.6). The 5-year overall survival rates in patients with low-grade versus high-grade tumors were 86 versus 63% (p = 0.1). Radiographic extension of disease into the olfactory groove, olfactory nerve, dura, and periorbita were statistically associated with decreased 5-year overall survival (5-year OS 49 vs. 91% [p = 0.04], 49 vs. 91% [p = 0.04], 44 vs. 92% [p = 0.02], and 44 vs. 80% [p = 0.04], respectively).

Conclusion ENBs are associated with a risk of regional failure. The current analysis suggests that Hyams low-grade and high-grade malignancies have comparable rates of early and delayed regional recurrences, although small sample size may limit our conclusions.

Keywords

head and neck - esthesioneuroblastoma - Hyams grade - regional failure - elective neck treatment - radiation - survival

Full Text

References

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