title: Olfactory neuroblastoma: a 35-year experience and suggested follow-up protocol.
abstract: OBJECTIVE
  To validate a follow-up protocol based on the long-term outcomes and recurrence rates in patients who have undergone surgical treatment for olfactory neuroblastoma.
  
  
  METHODS
  A prospective review of all patients treated for olfactory neuroblastoma at our institution over a 35-year period.
  
  
  RESULTS
  Ninety-five patients were treated from 1978 to 2013, with craniofacial (65 patients) or endoscopic resection (30 patients). Duration of follow-up ranged from 1 to 309 months (mean, 88.66 months). Fifty-six patients were alive and well, and 13 were alive with recurrent disease. Twenty-one patients had died of disease, and three had died of intercurrent disease. Overall survival was 83.4% at 5 years and 76.1% at 10 years. Disease-free survival at 5 years was 80% and at 10 years was 62.8%. A Cox regression analysis showed orbital extension and intracranial involvement to be significant independent factors affecting outcome. Local and regional recurrence occurred after an average of 49 months but with a range of 3 to 233 months.
  
  
  CONCLUSIONS
  In our series, olfactory neuroblastoma most commonly recurred within the first 4 years but can recur very late, after 19.4 years in one case. There is currently no universally accepted follow-up regime, but even late recurrence is eminently treatable. We therefore propose a protocol for lifelong follow-up with both clinical examination and serial imaging, including the neck and entire intracranial compartment.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology, Royal National Throat Nose & Ear Hospital, London, United Kingdom.
authors.forename: Joanne
authors.initials: J
authors.lastname: Rimmer
authors.forename: Valerie J
authors.initials: VJ
authors.lastname: Lund
authors.forename: Timothy
authors.initials: T
authors.lastname: Beale
authors.forename: William I
authors.initials: WI
authors.lastname: Wei
authors.forename: David
authors.initials: D
authors.lastname: Howard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D004724:Endoscopy / Q000379:methods; D018304:Esthesioneuroblastoma, Olfactory / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Olfactory neuroblastoma; craniofacial resection; endoscopic surgery; esthesioneuroblastoma