has been proposed as an adjunct to primary local therapy in esthesioneuroblastoma
(ON), but its role has not been precisely defined. Here, we evaluated its role in ENB treatment.
Materials and Methods:
The Surveillance Epidemiology and End Results
) database was queried for ENB/ON (International Classification of Diseases-3 9522). Cases met criteria for inclusion if they were unique, had a primary location in the nasal cavity, and had adequate information for Kadish staging derivation. Univariable and multivariable Cox analyses assessed chemotherapy
treatment effect on disease-specific survival
(DSS) and overall survival
(OS). Multiple imputation addressed missing data. A P
<0.05 was designated for statistical significance.
In adjusted multivariable analyses, chemotherapy
treatment was associated with inferior DSS (hazard ratio [HR], 1.74; 95% confidence interval [CI], 1.21-2.51; P
=0.003) and OS (HR, 1.71; 95% CI, 1.26-2.32; P
=0.001). Among the subset with local or regional disease treated with surgery and/or radiation therapy
remained associated with inferior outcomes DSS (HR, 2.78; 95% CI, 1.63-4.74; P
<0.001) and OS (HR, 2.18; 95% CI, 1.45-3.27; P
treatment misclassification did not explain these findings.
This analysis does not support chemotherapy
to improve either DSS or OS in primary ENB/ON treatment, after controlling for known ENB prognostic factors available from SEER
. Other prognostic and treatment selection factors could exist which were not controlled in these analyses. Chemotherapy
could beneficially affect outcomes other than DSS or OS. Although the concerns have been expressed regarding chemotherapy
treatment misclassification in SEER
, their analyses did not identify such misclassification as an explanation for our findings.