Regional Recurrences and Hyams Grade in Esthesioneuroblastoma

Hedyeh Ziai; Eugene Yu; Ilan Weinreb; Bayardo Perez-Ordonez; Christopher M K L Yao; Wei Xu; Dongyang Yang; Ian J Witterick; Eric Monteiro; Ralph W Gilbert; Jonathan C Irish; Patrick J Gullane; David P Goldstein; Jolie Ringash; Andrew Bayley; John R de Almeida

doi:10.1055/s-0040-1715809

Regional Recurrences and Hyams Grade in Esthesioneuroblastoma

J Neurol Surg B Skull Base. 2020 Oct 5;82(6):608-614. doi: 10.1055/s-0040-1715809. eCollection 2021 Dec.

Authors

Hedyeh Ziai¹, Eugene Yu², Ilan Weinreb³, Bayardo Perez-Ordonez³, Christopher M K L Yao¹, Wei Xu⁴, Dongyang Yang⁴, Ian J Witterick¹, Eric Monteiro¹, Ralph W Gilbert¹, Jonathan C Irish¹, Patrick J Gullane¹, David P Goldstein¹, Jolie Ringash⁵, Andrew Bayley⁵, John R de Almeida¹

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
² Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
³ Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
⁴ Department of Biostatistics, the Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada.
⁵ Department of Radiation Oncology, the Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

Abstract

Objective The aim of this study is to determine if Hyams grade may help predict which patients with esthesioneuroblastoma (ENB) tumors are likely to develop regional recurrences, and to determine the impact of tumor extent on regional failure in ENB patients without evidence of nodal disease at presentation. Design The study was designed as a retrospective review for ENB patients. Settings The study was prepared at tertiary care academic center for ENB patients. Participants Patients with ENB were included in the study. Main Outcome Measures Oncologic outcomes (5-year regional and locoregional control (LRC) and overall survival) in patients with Hyams low grade versus high grade. Oncologic outcomes based on radiographic disease extent. Results A total of 43 patients were included. Total 25 patients (58%) had Hyams low-grade tumor, and 18 (42%) had high-grade tumor. Of the 34 patients without regional disease at presentation, 8 (24%) were treated with elective nodal radiation. There were no statistically significant differences in 5-year regional control in the Hyams low-grade versus high-grade groups (78 vs. 89%; p = 0.4). The 5-year LRC rates in patients with low grade versus high grade were 73 versus 89% ( p = 0.6). The 5-year overall survival rates in patients with low-grade versus high-grade tumors were 86 versus 63% ( p = 0.1). Radiographic extension of disease into the olfactory groove, olfactory nerve, dura, and periorbita were statistically associated with decreased 5-year overall survival (5-year OS 49 vs. 91% [ p = 0.04], 49 vs. 91% [ p = 0.04], 44 vs. 92% [ p = 0.02], and 44 vs. 80% [ p = 0.04], respectively). Conclusion ENBs are associated with a risk of regional failure. The current analysis suggests that Hyams low-grade and high-grade malignancies have comparable rates of early and delayed regional recurrences, although small sample size may limit our conclusions.

Keywords: Hyams grade; elective neck treatment; esthesioneuroblastoma; head and neck; radiation; regional failure; survival.