목적: Olfactory neuroblastoma (ONB), a rare sinonasal malignancy, is conventionally treated with craniofacial resection, and often supplemented with adjuvant radiotherapy, particularly in advanced stages. Despite this, challenges persist in formulating optimal treatment strategies for early-stage ONB. This study analyzed treatment modalities and outcomes specific to early-stage ONB to refine treatment strategies for patients at the early stages of ONB. 방법:Patients treated for ONB in two tertiary hospitals were reviewed retrospectively from 1992 to 2021. Patient demographics, tumor grade, treatment modalities, and outcomes were analyzed. The definition of early stages was Dulgerov stage not exceeding 3 without any overt orbital invasion. Patients with cervical node or systemic metastasis at initial staging were excluded. 결과:Thirty-three patients were analyzed: 5 were T1, 27 were T2, and 4 were T3. Regarding tumor grade, there were Hyams grade I (n=1), grade II (n=18), and grade III (n=5), while information on the grade of others is missing. Thirty-three patients underwent surgery-based treatment, while the other 4 underwent RT-based treatment. Among those who underwent surgery, 18 had mass resection only, while the other 15 underwent craniofacial resection. Among the 33 patients who underwent surgery-based treatment, 22 had received adjuvant radiotherapy. No patients died of the disease during the study period. There was no significant difference in disease-free survival according to treatment modality (RT vs surgery-based treatment, log-rank p=0.739), extent of resection (mass resection vs craniofacial resection, log-rank p=0.262), adjuvant RT (with vs without adjuvant RT, log-rank p=0.537), and Hyams grade (low vs high, log-rank p=0.466). However, among the patients who underwent mass resection only, disease-free survival tended to be higher for those who had adjuvant RT (log-rank p=0.089) with significantly higher local free survival (log-rank p=0.009). Among those patients who underwent craniofacial resection, none of the patients showed local recurrences, and there was no significant difference in disease-free survival according to adjuvant RT (log-rank p=0.204) 결론:In early-stage ONB, overall survival appears promising irrespective of treatment modality. However, the role of definitive RT remains uncertain due to a limited number of patients. Adjuvant RT proves essential in mitigating local relapses for individuals who underwent mass resection without craniofacial resection. Conversely, the significance of adjuvant RT remains ambiguous for patients who underwent craniofacial resection. Further research and larger patient cohorts are warranted to better elucidate the optimal treatment strategies and the nuanced impact of adjuvant therapies in the management of early-stage ONB.