Olfactory Neuroblastoma: Clinical Features and Treatment Outcome.

Hwang, Sung Kyun; Seong, Weon Jin; Jeon, Yoon Kyung; Chi, Je G; Lee, Chull Hee; Jung, Hee Won

Original Article

Journal of Korean Neurosurgical Society 2003;33(5): 446-453.

Sung Kyun Hwang, Weon Jin Seong, Yoon Kyung Jeon, Je G Chi, Chull Hee Lee, Hee Won Jung

¹Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea. hwnjung@snu.ac.kr
²Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
³Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

OBJECTIVE
The authors analyzed clinical features, long-term treatment outcome, and prognostic factors of the olfactory neuroblastoma. METHODS: Twenty-one cases of olfactory neuroblastomas, treated from 1979 to 2000, were retrospectively reviewed with medical records and radiological findings. Mean follow-up periods are 28.7 months(range 4-178). Extent of tumor was classified by UCLA staging system. Statistical analysis for survival was done using Kaplan Meier method and log-lank test. RESULTS: Mean age was 27 years(13-62), and most common group are second decades(8/21, 38%). Male to female ratio was 13: 8. Common symptoms are nasal obstruction, epistaxis, exopthalmos and headache. There were three cases of T1, five T2, six T3, and seven T4 according to UCLA staging system. The 5-year survival rate was 21.3% and average time was 28.9 months in surgical resection group(n=14) as primary modality have higher survival rate than radiation and chemotherapy group(n=7)[2-year survival rate: 39.2% vs 14.3%, 5-year survival rate: 19.6% vs 14.3%(p=0.0274)]. Early stage(T1, T2) groups showed better survival rate than advanced(T3, T4) groups(38.1% vs 9.1% p=0.0336). The local and regional recurrences were observed in 6(27%) and 2(9%) cases. Mean recurrence free time was 7.8 months(range 1-25). CONCLUSION: Early detection and extent of resection are the important prognostic factors. Regular follow up is mandatary for the detection of recurrence or metastasis.

Key Words: Olfactory neuroblastoma; UCLA staging system; Radiation therapy; Metastasis; Chemotherapy; Recurrence