Hyams Grade and Ki-67 as Predictive Factors for Primary Treatment Failure in Olfactory Neuroblastoma.
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.
Methods: 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.
Results: 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.
Conclusions: 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. Methods: null