嗅神经母细胞瘤外科治疗分析

Surgical treatment and out come of olfactory neuroblastoma

目的总结嗅神经母细胞瘤外科治疗经验。方法回顾性分析2001年1月～2012年3月在我院接受手术治疗的49例嗅神经母细胞瘤病例资料,对预后因素及手术疗效进行研究。结果随访时间6～130个月,中位随访时间44个月。单纯鼻内镜手术31例,鼻内镜辅助手术4例,开放性手术14例。3、5年总体生存率分别为77.8%和69.2%,3、5年无病生存率分别为66.9%和63.2%。颅内受侵和切缘阳性分别为预后不良和复发的独立危险因素。结论鼻内镜手术适用于绝大多数嗅神经母细胞瘤病例,其远期疗效仍需进一步观察。

OBJECTIVE To summarize the experience of surgical treatment of olfactory neuroblastoma. METHODS A retrospective review of 49 patients with olfactory neuroblastoma operated in our hospital between January 2001 and March 2012 was performed. Prognostic factors and efficacy of surgical treatment were analyzed. RESULTS The median follow-up time was 44 months, with a range from 6 to 130 months. Thirty-one patients underwent endoscopic surgery alone, while 4 patients were treated with endoscope-assisted surgery and 14 patients by open surgery. The 3-year and 5-year overall survival（OS） rates were 77.8% and 69.2% respectively. The 3-year and 5-year disease free survival（DFS） rates were 66.9% and 63.2% respectively. Intracranial extension of the disease and positive surgical margins were independent predictors of worse OS and DFS on multivariate analysis. CONCLUSION This retrospective study demonstrates that the endoscopic surgery be suitable to most patients with olfactory neuroblastoma, but long-term follow-up is still necessary.