Early Versus Late Recurrence in Olfactory Neuroblastoma: A Multi‐Institutional Analysis of Predictive Risk Factors

作者：Alexandria Harris, Anthony Tang, Nicholas Fung, João Paulo Almeida, Pierre‐Olivier Champagne, Juan Fernandez-Miranda, Paul A. Gardner, Peter H. Hwang, Aristotelis Kalyvas, Zara M. Patel, Zara M. Patel, María Peris Celda, Carlos D. Pinheiro-Neto, Olabisi Sanusi, Carl H. Snyderman, Brian D. Thorp, Jamie J. Van Gompel, Georgios Zenonos, Nathan T. Zwagerman, Diana Bell, Edward C. Kuan, Eric W. Wang, Mathew Geltzeiler, Garret Choby · 发表于：International Forum of Allergy & Rhinology · 年份：2026 · DOI：10.1002/alr.70216 · 研究领域：Head and Neck Surgical Oncology、Cerebrospinal fluid and hydrocephalus、Sinusitis and nasal conditions

BACKGROUND: Olfactory neuroblastoma (ONB) exhibits variable recurrence patterns, with significant late recurrences occurring years after treatment. We investigated cutoff periods to define late recurrence and identified predictors that distinguish patients at risk of late recurrence from those considered cured. METHODS: From a multi-institutional cohort of 219 ONB patients treated at nine centers, we analyzed 77 patients with documented recurrence. Using a 48-month cutoff to define early (< 48 months) versus late (≥ 48 months) recurrence, we evaluated 35 clinical, anatomic, and treatment variables using Firth penalized logistic regression across three comparisons: (1) late versus early recurrence timing, (2) late recurrence versus no recurrence, and (3) early recurrence versus no recurrence. RESULTS: Thirty-four of the 77 (44.2%) recurrences were classified as late. Among the 77 patients who recurred, smaller tumor volume (OR 0.243, p = 0.035) and lower novel Dulguerov staging (OR 0.802, p = 0.038) were associated with late, rather than early recurrence. When patients with late recurrence were compared to those who remained disease-free, radiographic skull base bone involvement was the strongest independent predictor (OR 2.90, 95% CI 1.14-8.64, p = 0.025), and this effect strengthened after adjusting for tumor volume (OR 3.80, p = 0.029). Pathologic dural invasion (OR 3.29, p = 0.013), Kadish stage (OR 2.02, p = 0.026), and T-stage (OR 1.32, p = 0.040) were also significant. ...