Ryan M Carey1, Joseph Godovchik2, Alan D Workman1,3, Edward C Kuan1, Arjun K Parasher1,4, Jinbo Chen5, James N Palmer1, Nithin D Adappa1, Jason G Newman1, Jason A Brant1. 1. Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA. 2. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA. 3. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 4. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA. 5. Department of Biostatistics and Epidemiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
Abstract
BACKGROUND: Esthesioneuroblastomas (ENB) are uncommon and data regarding outcomes are often limited to single-institution series. The National Cancer Database (NCDB), which contains outcomes information from treatment centers across the United States, represents an opportunity to evaluate outcomes for rare diseases such as ENB across multiple institutions. METHODS: The NCDB was queried for location codes corresponding to the nasal cavity and paranasal sinuses and the histology code for ENB. Multivariate analyses were performed to evaluate for contributing factors to overall survival. RESULTS: A total of 1225 patients with ENB met the inclusion criteria. The 5-year overall survival was 76.2% (95% confidence interval [CI], 73.4-79.0%). Overall survival was associated with Kadish stage, grade, treatment sequence, margin status, Charlson/Deyo score, age, and gender (p < 0.05). Multivariate analysis demonstrated that, compared with surgery alone, surgery followed by radiation without chemotherapy had improved all-cause mortality (odds ratio [OR], 0.61; 95% CI, 0.40-0.95). Surgery with chemotherapy alone was associated with increased odds of all-cause mortality (OR, 4.86; 95% CI, 2.31-10.25). Multivariate subanalysis for Kadish stages A and B demonstrated no difference in survival between surgery and surgery followed by radiation, but surgery followed by chemoradiation had worse overall survival (OR, 3.03; 95% CI, 1.07-8.56). For Kadish stage C, surgery followed by radiation had improved overall survival compared with surgery alone (OR, 0.44; 95% CI, 0.24-0.81). CONCLUSION: The most common treatment for ENB is surgery followed by radiation, which is associated with the highest overall survival. The role of adjunctive chemotherapy needs to be re-evaluated in further studies.
BACKGROUND: Esthesioneuroblastomas (ENB) are uncommon and data regarding outcomes are often limited to single-institution series. The National Cancer Database (NCDB), which contains outcomes information from treatment centers across the United States, represents an opportunity to evaluate outcomes for rare diseases such as ENB across multiple institutions. METHODS: The NCDB was queried for location codes corresponding to the nasal cavity and paranasal sinuses and the histology code for ENB. Multivariate analyses were performed to evaluate for contributing factors to overall survival. RESULTS: A total of 1225 patients with ENB met the inclusion criteria. The 5-year overall survival was 76.2% (95% confidence interval [CI], 73.4-79.0%). Overall survival was associated with Kadish stage, grade, treatment sequence, margin status, Charlson/Deyo score, age, and gender (p < 0.05). Multivariate analysis demonstrated that, compared with surgery alone, surgery followed by radiation without chemotherapy had improved all-cause mortality (odds ratio [OR], 0.61; 95% CI, 0.40-0.95). Surgery with chemotherapy alone was associated with increased odds of all-cause mortality (OR, 4.86; 95% CI, 2.31-10.25). Multivariate subanalysis for Kadish stages A and B demonstrated no difference in survival between surgery and surgery followed by radiation, but surgery followed by chemoradiation had worse overall survival (OR, 3.03; 95% CI, 1.07-8.56). For Kadish stage C, surgery followed by radiation had improved overall survival compared with surgery alone (OR, 0.44; 95% CI, 0.24-0.81). CONCLUSION: The most common treatment for ENB is surgery followed by radiation, which is associated with the highest overall survival. The role of adjunctive chemotherapy needs to be re-evaluated in further studies.
Authors: Alyssa M Civantos; Shreya Viswanathan; Aman Prasad; Solymar Torres Maldonado; Robert M Brody; Steven B Cannady; Jason G Newman; Rabie M Shanti; Jason A Brant; Karthik Rajasekaran Journal: Eur Arch Otorhinolaryngol Date: 2021-01-03 Impact factor: 2.503
Authors: Khodayar Goshtasbi; Arash Abiri; Mehdi Abouzari; Ronald Sahyouni; Beverly Y Wang; Bobby A Tajudeen; Frank P K Hsu; Gilbert Cadena; Edward C Kuan Journal: Int Forum Allergy Rhinol Date: 2019-06-28 Impact factor: 3.858
Authors: Daniel O Kraft; Ryan M Carey; Aman Prasad; Karthik Rajasekaran; Michael A Kohanski; David W Kennedy; James N Palmer; Nithin D Adappa; Jason G Newman; Jason A Brant Journal: J Neurol Surg B Skull Base Date: 2021-06-10
Authors: Ryan M Carey; Ramie Fathy; Ravi R Shah; Karthik Rajasekaran; Steven B Cannady; Jason G Newman; Said A Ibrahim; Jason A Brant Journal: JAMA Netw Open Date: 2020-01-03
Authors: Christian M Meerwein; Panagiotis Balermpas; Domenic G Vital; Martina A Broglie; Michael B Soyka; David Holzmann Journal: Am J Rhinol Allergy Date: 2021-07-22 Impact factor: 2.467