Lee D Cranmer1,2, Bonny Chau1, Jason K Rockhill3, Manuel Ferreira4, Jay J Liao3. 1. Department of Medicine, Division of Oncology. 2. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA. 3. Department of Radiation Oncology. 4. Department of Neurological Surgery, University of Washington.
Abstract
OBJECTIVE: Chemotherapy has been proposed as an adjunct to primary local therapy in esthesioneuroblastoma (ENB)/olfactory neuroblastoma (ON), but its role has not been precisely defined. Here, we evaluated its role in ENB treatment. MATERIALS AND METHODS: The Surveillance Epidemiology and End Results (SEER) database was queried for ENB/ON (International Classification of Diseases-3 9522). Cases met criteria for inclusion if they were unique, had a primary location in the nasal cavity, and had adequate information for Kadish staging derivation. Univariable and multivariable Cox analyses assessed chemotherapy treatment effect on disease-specific survival (DSS) and overall survival (OS). Multiple imputation addressed missing data. A P<0.05 was designated for statistical significance. RESULTS: In adjusted multivariable analyses, chemotherapy treatment was associated with inferior DSS (hazard ratio [HR], 1.74; 95% confidence interval [CI], 1.21-2.51; P=0.003) and OS (HR, 1.71; 95% CI, 1.26-2.32; P=0.001). Among the subset with local or regional disease treated with surgery and/or radiation therapy, chemotherapy remained associated with inferior outcomes DSS (HR, 2.78; 95% CI, 1.63-4.74; P<0.001) and OS (HR, 2.18; 95% CI, 1.45-3.27; P<0.001). Chemotherapy treatment misclassification did not explain these findings. CONCLUSIONS: This analysis does not support chemotherapy to improve either DSS or OS in primary ENB/ON treatment, after controlling for known ENB prognostic factors available from SEER. Other prognostic and treatment selection factors could exist which were not controlled in these analyses. Chemotherapy could beneficially affect outcomes other than DSS or OS. Although the concerns have been expressed regarding chemotherapy treatment misclassification in SEER, their analyses did not identify such misclassification as an explanation for our findings.
OBJECTIVE: Chemotherapy has been proposed as an adjunct to primary local therapy in esthesioneuroblastoma (ENB)/olfactory neuroblastoma (ON), but its role has not been precisely defined. Here, we evaluated its role in ENB treatment. MATERIALS AND METHODS: The Surveillance Epidemiology and End Results (SEER) database was queried for ENB/ON (International Classification of Diseases-3 9522). Cases met criteria for inclusion if they were unique, had a primary location in the nasal cavity, and had adequate information for Kadish staging derivation. Univariable and multivariable Cox analyses assessed chemotherapy treatment effect on disease-specific survival (DSS) and overall survival (OS). Multiple imputation addressed missing data. A P<0.05 was designated for statistical significance. RESULTS: In adjusted multivariable analyses, chemotherapy treatment was associated with inferior DSS (hazard ratio [HR], 1.74; 95% confidence interval [CI], 1.21-2.51; P=0.003) and OS (HR, 1.71; 95% CI, 1.26-2.32; P=0.001). Among the subset with local or regional disease treated with surgery and/or radiation therapy, chemotherapy remained associated with inferior outcomes DSS (HR, 2.78; 95% CI, 1.63-4.74; P<0.001) and OS (HR, 2.18; 95% CI, 1.45-3.27; P<0.001). Chemotherapy treatment misclassification did not explain these findings. CONCLUSIONS: This analysis does not support chemotherapy to improve either DSS or OS in primary ENB/ON treatment, after controlling for known ENB prognostic factors available from SEER. Other prognostic and treatment selection factors could exist which were not controlled in these analyses. Chemotherapy could beneficially affect outcomes other than DSS or OS. Although the concerns have been expressed regarding chemotherapy treatment misclassification in SEER, their analyses did not identify such misclassification as an explanation for our findings.
Authors: Matt Lechner; Yoko Takahashi; Mario Turri-Zanoni; Jacklyn Liu; Nicholas Counsell; Mario Hermsen; Raman Preet Kaur; Tianna Zhao; Murugappan Ramanathan; Volker H Schartinger; Oscar Emanuel; Sam Helman; Jordan Varghese; Jozsef Dudas; Herbert Riechelmann; Susanne Sprung; Johannes Haybaeck; David Howard; Nils Wolfgang Engel; Sarah Stewart; Laura Brooks; Jessica C Pickles; Thomas S Jacques; Tim R Fenton; Luke Williams; Francis M Vaz; Paul O'Flynn; Paul Stimpson; Simon Wang; S Alam Hannan; Samit Unadkat; Jonathan Hughes; Raghav Dwivedi; Cillian T Forde; Premjit Randhawa; Simon Gane; Jonathan Joseph; Peter J Andrews; Gary Royle; Alessandro Franchi; Roberta Maragliano; Simonetta Battocchio; Helen Bewicke-Copley; Christodoulos Pipinikas; Amy Webster; Chrissie Thirlwell; Debbie Ho; Andrew Teschendorff; Tianyu Zhu; Christopher D Steele; Nischalan Pillay; Bart Vanhaesebroeck; Ahmed Mohyeldin; Juan Fernandez-Miranda; Ki Wan Park; Quynh-Thu Le; Robert B West; Rami Saade; R Peter Manes; Sacit Bulent Omay; Eugenia M Vining; Benjamin L Judson; Wendell G Yarbrough; Maddalena Sansovini; Nicolini Silvia; Ilaria Grassi; Alberto Bongiovanni; David Capper; Ulrich Schüller; Selvam Thavaraj; Ann Sandison; Pavol Surda; Claire Hopkins; Marco Ferrari; Davide Mattavelli; Vittorio Rampinelli; Fabio Facchetti; Piero Nicolai; Paolo Bossi; Oswaldo A Henriquez; Kelly Magliocca; C Arturo Solares; Sarah K Wise; Jose L Llorente; Zara M Patel; Jayakar V Nayak; Peter H Hwang; Peter D Lacy; Robbie Woods; James P O'Neill; Amrita Jay; Dawn Carnell; Martin D Forster; Masaru Ishii; Nyall R London; Diana M Bell; Gary L Gallia; Paolo Castelnuovo; Stefano Severi; Valerie J Lund; Ehab Y Hanna Journal: Eur J Cancer Date: 2021-12-31 Impact factor: 10.002
Authors: Lee D Cranmer; Bonny Chau; Jose G Mantilla; Elizabeth T Loggers; Seth M Pollack; Teresa S Kim; Edward Y Kim; Gabrielle M Kane; Matthew J Thompson; Jared L Harwood; Michael J Wagner Journal: Clin Orthop Relat Res Date: 2022-04-01 Impact factor: 4.755