Unit of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili - University of Brescia, Brescia, Italy.
Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS National Cancer Institute of Milan, University of Milan, Milan, Italy.
Head Neck. 2023 Jun;45(6):1486-1496. doi: 10.1002/hed.27361. Epub 2023 Mar 30.
Aim of this study is to investigate the prevalence of cervical nodal metastasis at presentation and as disease relapse in primary, treatment-naive olfactory neuroblastoma (ONB), and to review treatment modalities, risk factors for regional failure and survival outcomes according to nodal status.
A systematic review and proportion meta-analysis were conducted following PRISMA guidelines based on PubMed, Web of Science, and Scopus.
Eighteen articles were examined. The pooled proportion of patients with nodal metastasis at presentation (11.5%) was comparable to that of cN0 patients not receiving elective neck treatment developing nodal metastasis during follow-up (12.3%). Of the latter, most were Kadish stage C tumors (85.5%).
Cervical involvement is common both at presentation and during follow-up of cN0 ONB. The highest risk of developing late nodal metastasis is seen in cN0 patients with Kadish stage C tumors not receiving elective neck treatment. Elective cN0 neck treatment should be encouraged in selected patients to increase regional control.
本研究旨在调查初诊时及疾病复发时原发性、未经治疗的嗅神经母细胞瘤（ONB）颈部淋巴结转移的发生率，并根据淋巴结状态回顾治疗方式、局部失败的风险因素和生存结果。
根据 PRISMA 指南，我们在 PubMed、Web of Science 和 Scopus 上进行了系统回顾和比例荟萃分析。
共检查了 18 篇文章。初诊时存在淋巴结转移的患者的合并比例（11.5%）与未接受选择性颈部治疗的 cN0 患者在随访期间发生淋巴结转移的比例（12.3%）相当。在后一组中，大多数为 Kadish 分期 C 肿瘤（85.5%）。
cN0 ONB 患者在初诊时和随访期间均存在颈部受累。未接受选择性颈部治疗的 Kadish 分期 C 肿瘤的 cN0 患者发生晚期淋巴结转移的风险最高。应鼓励选择性的 cN0 颈部治疗，以增加区域控制率。
