Clin Exp Otorhinolaryngol.  2024 May;17(2):137-146. 10.21053/ceo.2023.00089.

Treatment Outcomes of Olfactory Neuroblastoma: A Multicenter Study by the Korean Sinonasal Tumor and Skull Base Surgery Study Group

• Hong SD
• Park SI
• Kim JH
• Heo SJ
• Cho SW
• Won TB
• Cho HJ
• Lee DH
• Mun SJ
• Park SK
• Kim YW
• Kim DY

• KMID: 2556004
• DOI: http://doi.org/10.21053/ceo.2023.00089

Abstract

Objectives
. Due to the rarity of olfactory neuroblastoma (ONB), there is ongoing debate about optimal treatment strategies, especially for early-stage or locally advanced cases. Therefore, our study aimed to explore experiences from multiple centers to identify factors that influence the oncological outcomes of ONB.
Methods
. We retrospectively analyzed 195 ONB patients treated at nine tertiary hospitals in South Korea between December 1992 and December 2019. Kaplan-Meier survival analysis was used to evaluate oncological outcomes, and a Cox proportional hazards regression model was employed to analyze prognostic factors for survival outcomes. Furthermore, we conducted 1:1 nearest-neighbor matching to investigate differences in clinical outcomes according to the use of neoadjuvant chemotherapy.
Results
. In our cohort, the 5-year overall survival (OS) rate was 78.6%, and the 5-year disease-free survival (DFS) rate was 62.4%. The Cox proportional hazards model revealed that the modified Kadish (mKadish) stage and Dulguerov T status were significantly associated with DFS, while the mKadish stage and Hyams grade were identified as prognostic factors for OS. The subgroup analyses indicated a trend toward improved 5-year DFS with dural resection in mKadish A and B cases, even though the result was statistically insignificant. Induction chemotherapy did not provide a survival benefit in this study after matching for the mKadish stage and nodal status.
Conclusion
. Clinical staging and pathologic grading are important prognostic factors in ONB. Dural resection in mKadish A and B did not show a significant survival benefit. Similarly, induction chemotherapy also did not show a survival benefit, even after stage matching.

Keyword

Esthesioneuroblastoma; Neoadjuvant Therapy; Prognosis; Treatment Outcome

Figure

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  Fig. 1. Overall survival and disease-free survival stratified by modified Kadish staging (A, D), Hyams grade (B, E), and resection margin (C, F).

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  Fig. 2. Overall survival and disease-free survival in patients at mKadish stages A and B according to surgical strategy (A, B), in mKadish stage C patients according to surgery-based treatment versus radiation-based treatment (C, D), and in patients with extensive intracranial invasion according to the use of neoadjuvant chemotherapy (E, F).

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