Recurrence Morbidity of Olfactory Neuroblastoma
Notice bibliographique
Résumé
Background: With modern treatment paradigms, olfactory neuroblastoma (ONB) has a favorable overall survival (OS); however, the incidence of recurrence remains high. The primary aims of this multi-institutional study were to delineate the prognosis of recurrence and explore how recurrence subsites associate with OS, disease-specific survival (DSS), and additional recurrence. Methods: Retrospective chart review of ONB cases from nine academic centers, between 2005 and 2021, was completed. Tumor characteristics, recurrence sub-sites (intracranial, local/ sinus and skull base, neck, and distant), timeline to recurrence, additional recurrence and survival estimates were determined using descriptive and time-to-event analyses. Results: A final study cohort of 233 patients were identified for study inclusion. A total of 70 (30.0%) subjects recurred within 50.4 months [SD ± 40.9] of initial diagnosis. The sub-sites of recurrence were local (50%), neck (36%), intracranial (9%), and distant (6%). Patients with second recurrence ( n = 13) consisted of neck (69%), distant (23%) and intracranial (8%) sub-sites. Patients who recurred had significantly different prevalence of AJCC T stage ( p < 0.001), AJCC overall stage ( p < 0.001), and modified Kadish staging ( p < 0.001) when compared with those without recurrence. Specific imaging findings, contributing to increased stage, and found to be significantly higher in the recurrent cohort included: skull base involvement on CT imaging (74.3% in recurrent group; 56.4% in nonrecurrent group; p = 0.007), periorbital involvement on MRI (25.7% in recurrent group; 12.3% in nonrecurrent; p = 0.019), and dural involvement on MRI (54.3% in recurrent group; 37.4% in nonrecurrent; p = 0.009). Histopathologically, dural involvement (50.0% in recurrent group; 36.2 in nonrecurrent; p = 0.037) and positive margins (31.4% in recurrent group; 21.5% in nonrecurrent; p = 0.022) are significantly higher in the recurrence group. Patients who recurred ( n = 70) had an OS of 43.4% at 60-months from the time of recurrence compared with the entire cohort ( n = 233) OS of 66.7% ( p = 0.839). First recurrence was significantly associated with worse 60-month DSS (HR = 5.62; 95%; p = 0.003) compared with the entire cohort. In addition, patients with either neck (DSS = 94.7% [SE ± 5.1%]) or local sinonasal/skull base recurrence (DSS = 80.3% [SE ± 7.3%]) have a significantly better DSS compared with intracranial recurrence (DSS = 62.5% [SE ± 21.3%]) or distant recurrence (DSS = 50.0% [SE ± 25.0%]). The worse prognosis for intracranial and distance recurrences was not significantly associated with initial tumor stage or Hyam's grade. Conclusions: Recurrent cases of ONB have significantly different AJCC T and overall stage as well as higher modified Kadish staging. Pre-operative imaging factors including skull base, dura and periorbita involvement were found to be statistically different and likely represent the more significant variables of increased staging. Recurrence of ONB was associated with a significantly worse DSS. Specifically, patients with local or neck recurrences have better DSS than those with intracranial or distant recurrence, independent of initial tumor stage or Hyam's grade. Generally, ONB patients have a better prognosis; however, there remains a high recurrence rate in this population. Identifying specific factors that confer increased risk of recurrence and DSS is important for patient counseling in addition to surveillance planning. Publication History Article published online: 01 February 2023 © 2023. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».