Affiliation:
1. Department of Otolaryngology Head and Neck Surgery University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA
2. UPMC Department of Otolaryngology Head and Neck Surgery Pittsburgh Pennsylvania USA
3. UPMC Department of Neurological Surgery Pittsburgh Pennsylvania USA
Abstract
AbstractObjectiveOlfactory neuroblastoma is a rare sinonasal malignancy with comparatively positive prognosis and survival, but with a range of biological behaviors that can be difficult to prognosticate with current means of risk stratification. Neutrophil‐to‐lymphocyte ratio (NLR) has been found across a diverse range of malignancies to be associated with poorer outcomes. This paper aims to elucidate the relationship of NLR with olfactory neuroblastoma to assess its prognostic value in this setting.Study DesignRetrospective chart review.SettingA single tertiary care academic hospital.MethodsThe study cohort included all patients treated for initial presentation of olfactory neuroblastoma from 2004 to 2020. NLR was calculated from preoperative labs, and each patient was evaluated for Kadish staging, Hyams grade, intraoperative positive margin, use of adjuvant therapy, posttreatment recurrence, and death. All statistical analysis was conducted using R and relationship between NLR and variables was assessed via binomial logistic regression.ResultsForty‐four patients were included, 24 were male. Average age 52.8, average length of follow‐up was 9.6 years. Patients were grouped by low (Kadish A/B) and advanced (Kadish C/D) stage, n = 23 and n = 21, respectively, and low (Hyams I/II) and high (Hyams III/IV) risk, n = 15 and n = 11, respectively. Advanced Kadish stage was associated with elevated NLR, odds ratio 5.69 [2.30, 20.7], P = .001. No other variables were associated with elevated NLR including Hyams grade, margin status, recurrence, and mortality.ConclusionHigher Kadish grade is associated with elevated NLR which may provide novel prognostic value to current risk‐stratifying systems.