PDF(Pubmed)
Abstract：
OBJECTIVE: 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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
目的：由于嗅神经母细胞瘤（ONB）的罕见，关于最佳治疗策略的争论正在进行，尤其是早期或局部晚期病例。因此,我们的研究旨在探索多个中心的经验,以确定影响ONB肿瘤结局的因素.
方法：我们回顾性分析了1992年12月至2019年12月在韩国9家三级医院接受治疗的195例ONB患者。Kaplan-Meier生存分析用于评估肿瘤学结果，采用Cox比例风险回归模型分析生存结局的预后因素.此外，我们进行了1:1最近邻匹配,以根据新辅助化疗的使用研究临床结局的差异.
结果：在我们的队列中，5年总生存率（OS）为78.6%，5年无病生存率(DFS)为62.4%。Cox比例风险模型显示，改良的Kadish（mKadish）阶段和DulguerovT状态与DFS显着相关，而mKadish分期和Hyams分级被确定为OS的预后因素。亚组分析表明，在mKadishA和B病例中，硬脑膜切除术后5年DFS有改善的趋势，即使结果在统计学上微不足道。在mKadish阶段和淋巴结状态匹配后，诱导化疗在这项研究中没有提供生存益处。
结论：临床分期和病理分级是ONB的重要预后因素。mKadishA和B的硬脑膜切除术未显示出明显的生存益处。同样，诱导化疗也没有显示出生存益处，即使在舞台匹配之后。
方法：我们回顾性分析了1992年12月至2019年12月在韩国9家三级医院接受治疗的195例ONB患者。Kaplan-Meier生存分析用于评估肿瘤学结果，采用Cox比例风险回归模型分析生存结局的预后因素.此外，我们进行了1:1最近邻匹配,以根据新辅助化疗的使用研究临床结局的差异.
结果：在我们的队列中，5年总生存率（OS）为78.6%，5年无病生存率(DFS)为62.4%。Cox比例风险模型显示，改良的Kadish（mKadish）阶段和DulguerovT状态与DFS显着相关，而mKadish分期和Hyams分级被确定为OS的预后因素。亚组分析表明，在mKadishA和B病例中，硬脑膜切除术后5年DFS有改善的趋势，即使结果在统计学上微不足道。在mKadish阶段和淋巴结状态匹配后，诱导化疗在这项研究中没有提供生存益处。
结论：临床分期和病理分级是ONB的重要预后因素。mKadishA和B的硬脑膜切除术未显示出明显的生存益处。同样，诱导化疗也没有显示出生存益处，即使在舞台匹配之后。
