2026 Poster Presentations
P299: DEVELOPMENT OF A WEB-BASED NOMOGRAM FOR PREDICTING SURVIVAL IN PATIENTS WITH ESTHESIONEUROBLASTOMA USING SEER DATABASE
Abhishek S Bhutada; Srijan Adhikari; Eric A Marvin; Carilion Clinic
Background: Esthesioneuroblastoma (ENB) is a rare neuroectodermal tumor arising from the olfactory epithelium. This study aimed to identify survival determinants and construct a prognostic web-based nomogram using the Surveillance, Epidemiology, and End Results (SEER) database records.
Methods: The SEER database, including 18 registries across the nation, was queried for patients diagnosed with ENB between 2000 and 2020. Patient demographics, tumor characteristics, and treatment data were analyzed using Cox Proportional Hazard models and Kaplan-Meier based survival plots. A web-based nomogram was constructed to predict 5- and 10-year survival probabilities individualized to a specific patient.
Results: A total of 941 patients were included in this analysis. Overall survival rates at 1-, 2-, 5-, and 10-years were 89%, 85%, 75%, and 58%, respectively. Multivariable analysis showed worse OS associated with age > 50 (p<0.001) and tumor size >6.0 cm (p<0.01). Compared to patients treated with gross total resection (GTR), worse OS was observed in those treated with chemotherapy only (p<0.01), chemotherapy and radiation (p<0.01), GTR with chemotherapy (p<0.05), radiation only (p<0.01), or no treatment (p<0.001). No statistically significant differences in OS were observed for patients treated with GTR with radiation, GTR with chemotherapy and radiation, subtotal resection (STR), or STR with adjuvant therapies when compared to GTR alone. Our web-based nomogram is publicly available (link). This model demonstrated a strong predictive performance, with a C-index of 0.73 (95% CI:0.65-0.81) and AUC of 0.75.
Conclusion: This is currently the largest retrospective cohort study to analyze survival determinants in patients with ENB. This is the first nomogram-based app developed for this specific patient population. We hope this will help guide clinicians to have more meaningful discussions with their patients and employ evidence-based practices.
Figure 1. Forest plot of multivariable Cox proportional hazard ratio for patient sex, patient age, tumor size, and treatment. Chemo – chemotherapy, rad – radiation therapy, GTR – gross total resection, STR – subtotal resection.
Figure 2. (A) Kaplan-Meier survival curve for total population of patients with ENB. (B) Kaplan-Meier survival curves categorized by patient sex. (C) Kaplan-Meier survival curves categorized by patient age. (D) Kaplan-Meier survival curves categorized by tumor size.
Figure 3. (A) Kaplan-Meier survival curves categorized by surgical treatment. (B) Kaplan-Meier survival curves categorized by radiation treatment. (C) Kaplan-Meier survival curves categorized by chemotherapy treatment.
Figure 4. ENB predictive nomogram performance measures. (A) Calibration plot and (B) a receiver operator curve (ROC) plot with area under the curve of 0.75 and C-index of 0.73 (95% CI:0.65-0.81).
