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J Neurol Surg B Skull Base 2021; 82(S 03): e131-e137
DOI: 10.1055/s-0039-3402026
Original Article

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

Kevin C. Miller 
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
,
Jamie J. Van Gompel 
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.
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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.

Keywords

esthesioneuroblastoma - induction - therapy - neoadjuvant - outcomes

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.




Publication History

Received: 10 June 2019

Accepted: 12 November 2019

Article published online:
14 January 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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