Surgical Treatment of Olfactory Neuroblastoma: Major Complication Rates, Progression Free and Overall Survival

• Published in: Journal of neurological surgery. Part B, Skull base Vol. 79; no. 2; pp. 151 - 155
• Main Authors: Wertz, Aileen, Hollon, Todd, Marentette, Lawrence J., Sullivan, Stephen E., McHugh, Jonathan B., McKean, Erin L.
• Format: Journal Article
• Language: English
• Published: Stuttgart · New York Georg Thieme Verlag KG 01-04-2018
• Subjects: Original; Original Article; endoscopic; recurrence; Kadish; complication; olfactory neuroblastoma; survival; Hyams
• ISSN: 2193-6331; 2193-634X
• DOI: 10.1055/s-0037-1605593

Abstract
Objective
 We aimed to compare major complication rates in patients undergoing open versus endoscopic resection of olfactory neuroblastoma (ONB) and to determine the prognostic utility of the Kadish staging and Hyams grading systems with respect to progression-free survival (PFS) and overall survival (OS).
Methods
 It is a retrospective review of experience in treating ONB at a single tertiary care hospital from 1987 through 2015. Major complications were defined as cerebrospinal fluid (CSF) leak, meningitis, osteomyelitis, tracheostomy, and severe neurologic injury.
Results
 Forty-one patients were included. An open approach was used in 34 (83%), endoscopic in 6 (15%), and combined in 1 (2%) case. Rates of major complications by surgical approach were 17% after endoscopic versus 31% after open (
p
 = 0.65). There was no significant difference in PFS or OS based on Kadish B versus C (PFS,
p
 = 0.28; OS,
p
 = 0.11) or Hyams grade 1 and 2 versus Hyams grade 3 and 4 (PFS,
p
 = 0.53; OS,
p
 = 0.38).
Conclusions
 There was no significant difference in major complications between open and endoscopic approaches for the treatment of ONB. Patient stratification using the Kadish staging and Hyams grading systems did not show significant differences in PFS or OS. Further research is needed to determine if a different staging system would better predict patient outcomes.