J Neurol Surg B
DOI: 10.1055/s-0039-3402026
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Induction Therapy Prior to Surgical Resection for Patients Presenting with Locally Advanced Esthesioneuroblastoma

1  Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, United States
,
John P. Marinelli
1  Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, United States
,
Jeffrey R. Janus
2  Department of Otolaryngology Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
Ashish V. Chintakuntlawar
3  Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, United States
,
Robert L. Foote
4  Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States
,
Michael J. Link
2  Department of Otolaryngology Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
5  Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
Garret Choby
2  Department of Otolaryngology Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
,
2  Department of Otolaryngology Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
5  Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States
› Author Affiliations
Funding None.
Further Information

Publication History

10 June 2019

12 November 2019

Publication Date:
14 January 2020 (online)

Abstract

Esthesioneuroblastoma (ENB) is a rare olfactory malignancy that can present with locally advanced disease. At our institution, patients with ENB in whom the treating surgeon believes that a margin-negative resection is initially not achievable are selected to undergo induction with chemotherapy with or without radiotherapy prior to surgery. In a retrospective review of 61 patient records, we identified six patients (10%) treated with this approach. Five of six patients (83%) went on to definitive surgery. Prior to surgery, three of five patients (60%) had a partial response after induction therapy, whereas two of five (40%) had stable disease. Microscopically margin-negative resection was achieved in four of five (80%) of the patients who went on to surgery, while one patient had negative margins on frozen section but microscopically positive margins on permanent section. Three of five patients (60%) recurred after surgery; two of these patients died with recurrent/metastatic ENB. In summary, induction therapy may facilitate margin-negative resection in locally advanced ENB. Given the apparent sensitivity of ENB to chemotherapy and radiotherapy, future prospective studies should investigate the optimal multidisciplinary approach to improve long-term survival in this rare disease.

Previous Presentation

This work was presented on February 15, 2019 as an oral abstract at the North American Skull Base Society 29th Annual Meeting in Orlando, Florida.