Koch Michael, Balk Mathias, Schlaffer Sven, Agaimy Abbas, Iro Heinrich, Müller Sarina
Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
Department of Neurosurgery, University of Erlangen-Nuremberg, Erlangen, Germany.
Laryngoscope. 2025 Oct;135(10):3691-3702. doi: 10.1002/lary.32238. Epub 2025 May 9.
BACKGROUND/OBJECTIVE: Tumor progression and first recurrence (TPR) after curative treatment for olfactory neuroblastoma can be regarded as primary treatment failure. Prognostic parameters for TPR and primary tumor-progression-free and recurrence-free survival (TPRFS) have not been sufficiently investigated in the literature.
Data for 43 patients were analyzed retrospectively to evaluate prognostic parameters for TPR after curative treatment for olfactory neuroblastoma: age, age < / ≥ 50 years, sex, tumor classifications, curative therapy (monotherapy vs. combined, R0 vs. R1/2/x resection), Hyams-grade (grades, grade I-II/III-IV), and Ki-67 labeling index (values, labeling index < / ≥ 10%). The primary endpoints were TPR and TPRFS. Parameters that were significant after univariate analysis and Kaplan-Meier survival analysis were included in multiple regression and Cox regression analysis.
After univariate analysis, younger age (p = 0.032) and higher Ki-67 values (p = 0.001) were significantly negatively associated with time to the development of TPR. TPRFS according to Kaplan-Meier was significantly poorer with Hyams-grade III-IV (p = 0.002) and Ki-67 ≥ 10% (p = 0.001). After Cox regression analysis, TPRFS according to Kaplan-Meier was weekly significantly poorer for younger age (p = 0.033) and highly significantly worse for Hyams-grade III-IV (p = 0.005) and a Ki-67 LI ≥ 10% (p = 0.009). Tumor-stage classifications and all therapeutical parameters were not significantly associated with TPRFS.
Out of a panel of parameters tested, younger age, Hyams-grade III-IV, and a Ki-67 LI ≥ 10% were significantly associated with a significantly worse TPRFS after multivariate Cox regression analysis. In particular, parameters such as Hyams-grade and the Ki-67 LI should be included in management considerations in olfactory neuroblastoma at an early stage.
背景/目的：嗅神经母细胞瘤根治性治疗后的肿瘤进展和首次复发（TPR）可视为原发性治疗失败。关于TPR以及原发性肿瘤无进展和无复发生存期（TPRFS）的预后参数在文献中尚未得到充分研究。
对43例患者的数据进行回顾性分析，以评估嗅神经母细胞瘤根治性治疗后TPR的预后参数：年龄、年龄＜/≥50岁、性别、肿瘤分类、根治性治疗（单一疗法与联合疗法、R0与R1/2/x切除）、海姆斯分级（分级，I-II级/III-IV级）以及Ki-67标记指数（数值，标记指数＜/≥10%）。主要终点为TPR和TPRFS。单因素分析和Kaplan-Meier生存分析后具有显著性的参数纳入多元回归和Cox回归分析。
单因素分析后，年龄较小（p = 0.032）和Ki-67值较高（p = 0.001）与TPR发生时间显著负相关。根据Kaplan-Meier分析，海姆斯分级III-IV级（p = 0.002）和Ki-67≥10%（p = 0.001）的TPRFS显著较差。Cox回归分析后，根据Kaplan-Meier分析，年龄较小的TPRFS每周显著较差（p = 0.033），海姆斯分级III-IV级（p = 0.005）和Ki-67 LI≥10%（p = 0.009）的TPRFS显著更差。肿瘤分期分类和所有治疗参数与TPRFS均无显著相关性。
在一组测试参数中，年龄较小、海姆斯分级III-IV级和Ki-67 LI≥10%在多因素Cox回归分析后与显著更差的TPRFS显著相关。特别是，海姆斯分级和Ki-67 LI等参数应在嗅神经母细胞瘤早期管理考虑中予以纳入。
