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242

KUANetal.

TABLE XXIV.A.2 (Continued)

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusions

Joshi et al. 413

N = 883 patients with ONB

OS

5- and 10-year survival for Kadish staging was 86.3% and 67.2% for Kadish A; 89.6% and 82.7% for Kadish B; 81.8% and 61.5% for Kadish C; and 60.0% and 29.5% for Kadish D Survival rates significantly dropped with increasing tumor stage (63.6% in stages A/B vs. 30% in stages C/D) and grade (100% in grades 1/2 vs. 31.3% in grades 3/4) 5-year OS was 86%, 90%, 76%, and 61% in Kadish stages A, B, C, and D, respectively Stage and Hyams grade did not influence survival Stage and Hyams grade prognostic for survival OS was associated with Kadish stage, grade, treatment sequence, margin status, Charlson/Deyo score, age, and gender ( p < 0.05) 5-year survival was 80.0% for Kadish A, 87.7% for Kadish B, 77.0% for Kadish C, and 49.5% for Kadish D The treatment characteristics between A/B could not explain survival differences

2019 4

Retrospective database study (NCDB)

Singh et al. 1347

2019 4

Retrospective case series

N = 21 patients with ONB

OS

Orton et al. 1365

N = 931 patients with ONB

OS

2018 4

Retrospective database study (NCDB) Retrospective case series Retrospective case series Retrospective database study (NCDB) Retrospective database study (NCDB) Retrospective database study (NCDB)

Wertz et al. 248

2018 4

N = 41 patients with ONB N = 32 patients with ONB N = 1225 patients with ONB

OS

Woods et al. 1378

2018 4

OS

Carey et al. 1383

2017 4

OS

Konuthula et al. 1384

N = 1167 patients with ONB

OS

2017 4

Xiong et al. 1366

2017 4

N = 1167 patients with ONB

OS

Abbreviations: DFS, disease-free survival; NCDB, National Cancer DataBase; ONB, olfactory neuroblastoma (esthesioneuroblastoma); OS, overall survival; PFS, progression-free survival; RT, radiation therapy; SEER, Surveillance, Epidemiology, and End Results.

Staging systems in ONB

Value

Some staging systems (i.e., Kadish) were initially developed in the pre-endoscopic era and may not take into consideration all relevant prognosticators. Newer staging systems have not been fully validated.

judgments

Aggregate grade of evidence

B (Level 2: three studies; Level 4: 13 studies)

Benefit

Staging ONB extent provides prognostic information that may guide adjuvant therapy and allow for ease of communication to multidisciplinary and cross-institutional teams. There are multiple staging systems with unique criteria, with overlapping and sometimes conflicting prognostic value. There are no studies investigating the costs of ONB staging.

Policy level Recommendation. Intervention ONB staging systems are a useful measure for describing tumors, prognostication, and treatment planning, though other important tumor factors (e.g., grade, dural invasion) must also be considered. 3 Management of the neck This section is an evidence-based update to ICSB 2019 regarding management of the neck. 5 In the past 5 years since that consensus statement, there have

Harm

Cost

Benefits–harm assessment

Preponderance of benefits over harm.

(Continued)