Lymph node metastasis from olfactory neuroblastoma at presentation and as disease relapse: A systematic review and proportion meta-analysis of prevalence data and variables influencing regional control

BackgroundAim of this study is to investigate the prevalence of cervical nodal metastasis at presentation and as disease relapse in primary, treatment-naive olfactory neuroblastoma (ONB), and to review treatment modalities, risk factors for regional failure and survival outcomes according to nodal status. MethodsA systematic review and proportion meta-analysis were conducted following PRISMA guidelines based on PubMed, Web of Science, and Scopus. ResultsEighteen articles were examined. The pooled proportion of patients with nodal metastasis at presentation (11.5%) was comparable to that of cN0 patients not receiving elective neck treatment developing nodal metastasis during follow-up (12.3%). Of the latter, most were Kadish stage C tumors (85.5%). ConclusionsCervical involvement is common both at presentation and during follow-up of cN0 ONB. The highest risk of developing late nodal metastasis is seen in cN0 patients with Kadish stage C tumors not receiving elective neck treatment. Elective cN0 neck treatment should be encouraged in selected patients to increase regional control.

Automated summary

The aim of this study was to investigate the prevalence of cervical nodal metastasis in primary, treatment-naive olfactory neuroblastoma (ONB) at presentation and as disease relapse, as well as to review treatment modalities and risk factors for regional failure and survival outcomes based on nodal status. A systematic review and meta-analysis were conducted based on PubMed, Web of Science, and Scopus. The results showed that cervical nodal involvement is common in both the presentation and during follow-up of cN0 ONB. The highest risk of developing late nodal metastasis is seen in cN0 patients with Kadish stage C tumors not receiving elective neck treatment. Based on these findings, selective neck treatment should be encouraged in selected patients to improve regional control.