Comparing Kadish, TNM, and the modified Dulguerov staging systems for esthesioneuroblastoma Journal Article


Authors: Joshi, R. R.; Husain, Q.; Roman, B. R.; Cracchiolo, J.; Yu, Y.; Tsai, J.; Kang, J.; McBride, S.; Lee, N. Y.; Morris, L.; Ganly, I.; Tabar, V.; Cohen, M. A.
Article Title: Comparing Kadish, TNM, and the modified Dulguerov staging systems for esthesioneuroblastoma
Abstract: Background: Esthesioneuroblastoma (ENB) is a rare neuroendocrine tumor. The purpose of this study was to compare the Kadish, tumor-node-metastasis (TNM), and Dulguerov's modified TNM staging in order to determine the impact of the stage on primary surgical treatment selection, margin status, and survival. Methods: The National Cancer Database (NCDB) was used to identify patients diagnosed with ENB between 2004 to 2015. Patients were excluded based on the ability to properly stage their disease as well as the availability of treatment data. Results: Eight-hundred eighty-three patients had sufficient data for analysis. On multivariate analysis, age and government insurance were associated with primary surgical treatment, whereas tumor stage, gender, race, hospital type and volume, and comorbidity score were not. Age, charlson-deyo comorbidity (CDCC) score, hospital volume, and nodal status were found to be predictors of survival. Multivariate-analysis controlling for stage failed to demonstrate clear survival differences between staging in both TNM and Kadish systems. T-stage and the presence of regional nodal metastasis were associated with an increased risk of positive margins on multivariate analysis. Conclusion: Although primary surgical management and positive margins can be predicted by certain patient and tumor factors, clinical staging systems for ENB poorly predict prognosis over a 10-year horizon. © 2018 Wiley Periodicals, Inc.
Keywords: adult; cancer survival; controlled study; aged; middle aged; survival analysis; cancer surgery; survival rate; major clinical study; overall survival; case control study; cancer patient; comparative study; cancer staging; lymph node metastasis; antineoplastic agent; cohort analysis; risk factor; age; health insurance; government; cancer center; correlation coefficient; comorbidity; gender; esthesioneuroblastoma; race; surgical margin; clinical outcome; hospital volume; survival prediction; cancer prognosis; very elderly; human; male; female; priority journal; article; comorbidity assessment; national cancer database; sinonasal malignancies; sinonasal neoplasm; charlson deyo comorbidity score; kadish staging; modified dulguerov staging
Journal Title: Journal of Surgical Oncology
Volume: 119
Issue: 1
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2019-01-01
Start Page: 130
End Page: 142
Language: English
DOI: 10.1002/jso.25293
PROVIDER: scopus
PUBMED: 30466166
DOI/URL:
Notes: J. Surg. Oncol. -- Export Date: 2 January 2019 -- Article -- CODEN: JSONA C2 - 30466166 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Viviane S Tabar
    117 Tabar
  2. Nancy Y. Lee
    547 Lee
  3. Luc Morris
    123 Morris
  4. Ian Ganly
    229 Ganly
  5. Benjamin Raphael Roman
    44 Roman
  6. Sean Matthew McBride
    109 McBride
  7. Chiaojung Jillian   Tsai
    82 Tsai
  8. Marc A Cohen
    17 Cohen
  9. Yao Yu
    2 Yu
  10. Jung Yun Kang
    1 Kang