Treatment Strategies for Recurrent Olfactory Neuroblastoma

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Abstract
This study aimed to describe how olfactory neuroblastoma (ONB) recurrences are managed and whether these salvage strategies lead to freedom from disease at the location of recurrence. Retrospective cross-sectional analysis. Single academic hospital in the United States. Patients with recurrent ONB undergoing salvage treatment from April 2006 to February 2021. Persistence or freedom from recurrent disease. A total of 27 cases were identified. Among these cases, 59 recurrences were observed. The mean time to recurrence was 72 months. The mean duration from time of recurrence management to most recent follow-up was 59 months. A total of 19 cases underwent surgery for local sinonasal or local intracranial disease, 20 cases underwent surgery for regional disease, 2 underwent surgery for distant extracranial disease, and no patients underwent surgery for distant intracranial disease. About 22 recurrences were treated with radiation, 8 recurrences were treated with chemotherapy or immunotherapy, and 9 recurrences were treated with radioligand therapy. About 5 patients (20%) had 1-year disease-free survival following salvage treatment and 4 patients (16%) had 5-year disease-free survival following salvage treatment. Surgery, radiation, and radioligand therapy were the most common salvage treatments used for recurrent OBN. Local sinonasal, local intracranial, and regional recurrences were primarily managed surgically, whereas distal intracranial and distant disease were most often treated with radiation or radioligand therapy. This report is the first to characterize treatment strategies and outcomes used for specific locations of recurrences.

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