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KUANetal.

TABLE XXIV.A.3 Evidence surrounding management of the neck in ONB.

Clinical endpoints Conclusions

Study

Year LOE Study design Study groups

Wuet al. 47

OS

1. For ONB with orbital invasion, median duration of survival was 124.0 months and 5-year OS was 67.1% 2. Patients with orbital invasion and lymph node metastasis had worse outcomes At presentation, positive lymph nodes present 20% Delayed neck recurrence was lower in irradiated N0 neck (6.4% vs. 34%) Delayed regional nodal metastasis occurred in 22% of patients (median 57months) 1. In adjusted multivariable analyses, chemotherapy treatment was associated with inferior DSS 2. Among the subset with local or regional disease treated with surgery and/or RT, chemotherapy remained associated with inferior outcomes 3. This analysis does not support chemotherapy to improve either DSS or OS in primary ONB/ON treatment, after controlling for known ONB prognostic factors available from SEER Multivariate analysis demonstrated lymph node status, orbital invasion, and the combination of surgery and RT to be independent prognostic factors High Hyams grade and node-positive patient had worse DFS Age, Charlson–Deyo comorbidity score, hospital volume, and nodal status were found to be predictors of survival 1. Overall cervical metastasis rate was 8.7%; level II most common 2. 4.5% cases had multiple positive nodal basins 3. Male sex and higher tumor grade predicted nodal metastases 4. Nodal metastases did not predict OS and DFS and multivariate regression

22 studies; N = 104 ONB with orbital invasion

2022 2

Systematic

reviewand meta analysis

Safi et al. 33

2020 2

Systematic

Seven studies; N = 94 with pediatric ONB

OS

reviewand meta analysis

Abdelmeguid et al. 412

2022 4

Retrospective case series Retrospective case series Retrospective database study (SEER)

N = 139 patients with ONB N = 143 patients with ONB

OS

McMillian et al. 42

2022 4

OS

Cranmer

N = 797 patients with ONB

1. OS 2. DSS

2020 4

et al. 1371

Songet al. 457

2020 4

Retrospective case series

N = 217 patients with ONB

OS

Wolfe et al. 1346

2020 4

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

N = 39 patients with ONB N = 883 patients with ONB

1. OS 2. DFS

Joshi et al. 413

2019 4

OS

Kuanet al. 1335

N = 381 patients with ONB

1. Cervical nodal metas tases 2. OS 3. DFS

2019 4

Klironomos et al. 1352 1. Delayed neck recurrence 20% 2. No local recurrence in mean 75 months follow-up Abbreviations: DFS, disease-free survival; DSS, disease-specific survival; NCDB, National Cancer DataBase; ONB, olfactory neuroblastoma (esthesioneuroblas toma); OS, overall survival; PFS, progression-free survival; RT, radiation therapy; SEER, Surveillance, Epidemiology, and End Results. 2018 4 Retrospective case series N = 10 ONB by endoscopic surgery OS