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Peer-reviewedCC BY 4.0International Forum of Allergy & Rhinology

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

  • Alexandria Harris1
  • Anthony Tang1
  • Nicholas Fung1
  • Joao Paulo Almeida2
  • Pierre‐Olivier Champagne3
  • Juan Fernandez‐Miranda4
  • Paul A. Gardner5
  • Peter Hwang6
  • Aristotelis Kalyvas7
  • Chirag Patel8
  • Zara M. Patel6
  • Maria Peris Celda9
12 more authors
  • Carlos D. Pinheiro‐Neto10
  • Olabisi Sanusi11
  • Carl H. Snyderman1
  • Brian D. Thorp12
  • Jamie J. Van Gompel9
  • Georgios Zenonos13
  • Nathan T. Zwagerman14
  • Diana Bell15
  • Edward C. Kuan16
  • Eric W. Wang1
  • Mathew Geltzeiler17
  • Garret Choby1
17 affiliations
  1. 1Department of Otolaryngology—Head and Neck Surgery University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA
  2. 2Department of Neurological Surgery Indiana University School of Medicine Indianapolis Indiana USA
  3. 3Department of Neurological Surgery Universite Laval Quebec City Quebec Canada
  4. 4Department of Neurological Surgery Stanford University Palo Alto California USA
  5. 5Department of Neurological Surgery NYU Langone Health New York New York USA
  6. 6Department of Otolaryngology—Head and Neck Surgery Stanford University Palo Alto California USA
  7. 7Department of Neurological Surgery University of Toronto Toronto Ontario Canada
  8. 8Department of Otolaryngology—Head and Neck Surgery Loyola University Medical Center Maywood Illinois USA
  9. 9Department of Neurological Surgery Mayo Clinic Rochester Minnesota USA
  10. 10Department of Otolaryngology—Head and Neck Surgery NYU Langone Health New York New York USA
  11. 11Department of Neurological Surgery Oregon Health & Science University Portland Oregon USA
  12. 12Department of Otolaryngology—Head and Neck Surgery University of North Carolina Chapel Hill North Carolina USA
  13. 13Department of Neurological Surgery University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA
  14. 14Department of Neurological Surgery Medical College of Wisconsin Milwaukee Wisconsin USA
  15. 15Department of Pathology and Laboratory Medicine University of Pittsburgh Pittsburgh Pennsylvania USA
  16. 16Department of Otolaryngology—Head and Neck Surgery University of California Irvine California USA
  17. 17Department of Otolaryngology—Head and Neck Surgery Oregon Health & Science University Portland Oregon USA
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Abstract

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.

Conclusions: A 48‐month cutoff effectively stratifies ONB recurrence risk. Skull base bone involvement independently predicts recurrence when compared to nonrecurrent cases and uniquely persists as a risk factor for late recurrence. These findings establish skull base bone involvement as a novel biomarker for risk‐stratified surveillance protocols.

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Cite

BibTeXRIS
BibTeX
@article{harris2026early,
  title = {{Early Versus Late Recurrence in Olfactory Neuroblastoma: A Multi‐Institutional Analysis of Predictive Risk Factors}},
  author = {Alexandria Harris and Anthony Tang and Nicholas Fung and Joao Paulo Almeida and Pierre‐Olivier Champagne and Juan Fernandez‐Miranda and Paul A. Gardner and Peter Hwang and Aristotelis Kalyvas and Chirag Patel and Zara M. Patel and Maria Peris Celda and Carlos D. Pinheiro‐Neto and Olabisi Sanusi and Carl H. Snyderman and Brian D. Thorp and Jamie J. Van Gompel and Georgios Zenonos and Nathan T. Zwagerman and Diana Bell and Edward C. Kuan and Eric W. Wang and Mathew Geltzeiler and Garret Choby},
  journal = {International Forum of Allergy \& Rhinology},
  year = {2026},
  month = jul,
  doi = {10.1002/alr.70216},
  url = {https://doi.org/10.1002/alr.70216},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Early Versus Late Recurrence in Olfactory Neuroblastoma: A Multi‐Institutional Analysis of Predictive Risk Factors
AU  - Alexandria Harris
AU  - Anthony Tang
AU  - Nicholas Fung
AU  - Joao Paulo Almeida
AU  - Pierre‐Olivier Champagne
AU  - Juan Fernandez‐Miranda
AU  - Paul A. Gardner
AU  - Peter Hwang
AU  - Aristotelis Kalyvas
AU  - Chirag Patel
AU  - Zara M. Patel
AU  - Maria Peris Celda
AU  - Carlos D. Pinheiro‐Neto
AU  - Olabisi Sanusi
AU  - Carl H. Snyderman
AU  - Brian D. Thorp
AU  - Jamie J. Van Gompel
AU  - Georgios Zenonos
AU  - Nathan T. Zwagerman
AU  - Diana Bell
AU  - Edward C. Kuan
AU  - Eric W. Wang
AU  - Mathew Geltzeiler
AU  - Garret Choby
PY  - 2026
DA  - 2026/07/09
JO  - International Forum of Allergy & Rhinology
DO  - 10.1002/alr.70216
UR  - https://doi.org/10.1002/alr.70216
AB  - 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.  Conclusions: A 48‐month cutoff effectively stratifies ONB recurrence risk. Skull base bone involvement independently predicts recurrence when compared to nonrecurrent cases and uniquely persists as a risk factor for late recurrence. These findings establish skull base bone involvement as a novel biomarker for risk‐stratified surveillance protocols.
SN  - 2042-6976
SN  - 2042-6984
ER  -