A single center Retrospective review of patients with Esthesioneuroblastoma

Summary: Esthesioneuroblastoma (ENB) is a rare and aggressive malignant neoplasm originating from the olfactory neuroepithelium. This rare tumor poses significant challenges in its management due to its aggressive nature and the absence of standardized treatment guidelines. Despite advancements in diagnostic modalities and treatment options, the prognosis for ENB remains variable, emphasizing the need for a deeper understanding of its clinical characteristics and treatment response. This is a single institution retrospective analysis of patients with ENB who were treated at a single institution from 2011 to 2023. Electronic medical records were used to collect data. Median follow-up was defined as time from initial surgery to most recent follow-up. Descriptive statistics were used to summarize tumor characteristics and treatment modalities. Kaplan-Meier analysis was performed to assess overall survival, while progression-free survival was calculated from the time of initial surgery to disease progression. The association between treatment modalities and recurrence status was examined using Kruskal-Wallis tests. Statistical analysis was conducted using SAS v9.4 software. 20 patients diagnosed with esthesioneuroblastoma (ENB) were identified for the purpose of this study from 2011-2023. The median follow-up time was 27.9 months. The average age at diagnosis was 52.3 years (SD=18.2). Most patients presented with Kaddish Stage C tumors (n=13, 81.3%) and did not have positive lymph nodes (n=13, 81.3%). Out of the 20 eligible patients, 6 (35.3%) received chemotherapy, and 12 (75.0%) underwent radiation therapy. During the follow-up period, 8 patients (50.0%) experienced disease recurrence. At the time of the last follow-up, 14 patients were alive and under active surveillance. The first quartile of overall survival was 59.6 months. Radiation therapy was significantly associated with overall survival (p = 0.0016), although median overall survival could not be established due to the small sample size. Our study, underscores the challenges inherent in treating ENB due to the lack of standardized guidelines. Despite these challenges, we observed that the majority of patients presented with advanced-stage disease, emphasizing the need for early detection and intervention strategies. While our study is limited by small sample size, we observed that the age at diagnosis had no association with OS or recurrence status, treatment regimens in general had little bearing on OS and recurrence status and radiation therapy and type of radiation therapy used having potential associations with each. Overall, this study contributes to the growing body of literature on ENB and underscores the importance of multidisciplinary approaches in its management and the need for a more comprehensive multi-institution study would assist with clarifying these associations. Laxmi Alekhya Mitta, n/a (Presenting Author) - University of Oklahoma, Hudson college of Public Health; Patricia Pius (she/her/hers), MD (Co-Author) - University of Oklahoma; Christina Henson, MD (Co-Author) - University of Oklahoma; Jo-Elle Peterson, MD (Co-Author) - University of Oklahoma; Minh Phan, MD (Co-Author) - University of Oklahoma; Jack Owen, MD (Co-Author) - University of Oklahoma; Michael Machiorlatti, MD (Co-Author) - University of Oklahoma