Dural Invasion Predicts the Laterality and Development of Neck Metastases in Esthesioneuroblastoma

John P. Marinelli, Jeffrey R. Janus, Jamie Van Gompel, Michael J. Link, Eric J. Moore, Kathryn M. van Abel, Brandon W. Peck, Christine M. Lohse, Daniel L. Price

Research output: Contribution to journalArticle

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Abstract

Objectives Neck metastases in patients with esthesioneuroblastoma (ENB) constitute the most significant predictor of poor long-term survival. Recently, researchers discovered the existence of dural lymphatic channels that drain to the cervical lymph nodes. From this physiologic basis, we hypothesized that patients with ENB who develop dural invasion (DI) would exhibit a proclivity for neck metastases. Design Retrospective review. Setting Tertiary referral center. Participants All patients treated for ENB from January 1, 1994 to December 31, 2015. Main Outcome Measures Incidence, laterality, and recurrence rate of neck metastases by DI status. Results Sixty-one patients were identified (38% female; median age 49, range, 10–80), 34 (56%) of whom had DI and 27 (44%) did not. Of patients with DI, 50% presented with or developed neck disease following treatment compared with just 22% of those without DI ( p = 0.026). Bilateral neck disease was more common in patients with DI (11/34, 32%) compared with those without (2/27, 7%) ( p = 0.018). Five-year regional recurrence-free survival rates were 88% for those without and 64% for those with DI ( p = 0.022). Kadish C patients with DI were more likely to develop regional recurrence when compared with Kadish C without DI and Kadish A/B ( p = 0.083). Further, Kadish C patients with DI displayed worse overall survival than Kadish C without DI and Kadish A/B. Kadish D patients displayed the worst overall survival. The difference in overall survival among these four groups was significant ( p < 0.001). Conclusion DI by ENB is associated with increased incidence of cervical nodal metastases, bilateral neck disease, worse regional recurrence-free survival, and poorer overall survival. These data support the division of Kadish C by DI status.

Original languageEnglish (US)
JournalJournal of Neurological Surgery, Part B: Skull Base
DOIs
StateAccepted/In press - Feb 22 2018

Fingerprint

Olfactory Esthesioneuroblastoma
Neck
Neoplasm Metastasis
Survival
Recurrence
Incidence
Tertiary Care Centers
Survival Rate
Lymph Nodes
Research Personnel
Outcome Assessment (Health Care)

Keywords

  • dural invasion
  • elective neck treatment
  • esthesioneuroblastoma
  • neck metastases
  • olfactory neuroblastoma

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Dural Invasion Predicts the Laterality and Development of Neck Metastases in Esthesioneuroblastoma. / Marinelli, John P.; Janus, Jeffrey R.; Van Gompel, Jamie; Link, Michael J.; Moore, Eric J.; van Abel, Kathryn M.; Peck, Brandon W.; Lohse, Christine M.; Price, Daniel L.

In: Journal of Neurological Surgery, Part B: Skull Base, 22.02.2018.

Research output: Contribution to journalArticle

Marinelli, John P. ; Janus, Jeffrey R. ; Van Gompel, Jamie ; Link, Michael J. ; Moore, Eric J. ; van Abel, Kathryn M. ; Peck, Brandon W. ; Lohse, Christine M. ; Price, Daniel L. / Dural Invasion Predicts the Laterality and Development of Neck Metastases in Esthesioneuroblastoma. In: Journal of Neurological Surgery, Part B: Skull Base. 2018.
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abstract = "Objectives Neck metastases in patients with esthesioneuroblastoma (ENB) constitute the most significant predictor of poor long-term survival. Recently, researchers discovered the existence of dural lymphatic channels that drain to the cervical lymph nodes. From this physiologic basis, we hypothesized that patients with ENB who develop dural invasion (DI) would exhibit a proclivity for neck metastases. Design Retrospective review. Setting Tertiary referral center. Participants All patients treated for ENB from January 1, 1994 to December 31, 2015. Main Outcome Measures Incidence, laterality, and recurrence rate of neck metastases by DI status. Results Sixty-one patients were identified (38{\%} female; median age 49, range, 10–80), 34 (56{\%}) of whom had DI and 27 (44{\%}) did not. Of patients with DI, 50{\%} presented with or developed neck disease following treatment compared with just 22{\%} of those without DI ( p = 0.026). Bilateral neck disease was more common in patients with DI (11/34, 32{\%}) compared with those without (2/27, 7{\%}) ( p = 0.018). Five-year regional recurrence-free survival rates were 88{\%} for those without and 64{\%} for those with DI ( p = 0.022). Kadish C patients with DI were more likely to develop regional recurrence when compared with Kadish C without DI and Kadish A/B ( p = 0.083). Further, Kadish C patients with DI displayed worse overall survival than Kadish C without DI and Kadish A/B. Kadish D patients displayed the worst overall survival. The difference in overall survival among these four groups was significant ( p < 0.001). Conclusion DI by ENB is associated with increased incidence of cervical nodal metastases, bilateral neck disease, worse regional recurrence-free survival, and poorer overall survival. These data support the division of Kadish C by DI status.",
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T1 - Dural Invasion Predicts the Laterality and Development of Neck Metastases in Esthesioneuroblastoma

AU - Marinelli, John P.

AU - Janus, Jeffrey R.

AU - Van Gompel, Jamie

AU - Link, Michael J.

AU - Moore, Eric J.

AU - van Abel, Kathryn M.

AU - Peck, Brandon W.

AU - Lohse, Christine M.

AU - Price, Daniel L.

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N2 - Objectives Neck metastases in patients with esthesioneuroblastoma (ENB) constitute the most significant predictor of poor long-term survival. Recently, researchers discovered the existence of dural lymphatic channels that drain to the cervical lymph nodes. From this physiologic basis, we hypothesized that patients with ENB who develop dural invasion (DI) would exhibit a proclivity for neck metastases. Design Retrospective review. Setting Tertiary referral center. Participants All patients treated for ENB from January 1, 1994 to December 31, 2015. Main Outcome Measures Incidence, laterality, and recurrence rate of neck metastases by DI status. Results Sixty-one patients were identified (38% female; median age 49, range, 10–80), 34 (56%) of whom had DI and 27 (44%) did not. Of patients with DI, 50% presented with or developed neck disease following treatment compared with just 22% of those without DI ( p = 0.026). Bilateral neck disease was more common in patients with DI (11/34, 32%) compared with those without (2/27, 7%) ( p = 0.018). Five-year regional recurrence-free survival rates were 88% for those without and 64% for those with DI ( p = 0.022). Kadish C patients with DI were more likely to develop regional recurrence when compared with Kadish C without DI and Kadish A/B ( p = 0.083). Further, Kadish C patients with DI displayed worse overall survival than Kadish C without DI and Kadish A/B. Kadish D patients displayed the worst overall survival. The difference in overall survival among these four groups was significant ( p < 0.001). Conclusion DI by ENB is associated with increased incidence of cervical nodal metastases, bilateral neck disease, worse regional recurrence-free survival, and poorer overall survival. These data support the division of Kadish C by DI status.

AB - Objectives Neck metastases in patients with esthesioneuroblastoma (ENB) constitute the most significant predictor of poor long-term survival. Recently, researchers discovered the existence of dural lymphatic channels that drain to the cervical lymph nodes. From this physiologic basis, we hypothesized that patients with ENB who develop dural invasion (DI) would exhibit a proclivity for neck metastases. Design Retrospective review. Setting Tertiary referral center. Participants All patients treated for ENB from January 1, 1994 to December 31, 2015. Main Outcome Measures Incidence, laterality, and recurrence rate of neck metastases by DI status. Results Sixty-one patients were identified (38% female; median age 49, range, 10–80), 34 (56%) of whom had DI and 27 (44%) did not. Of patients with DI, 50% presented with or developed neck disease following treatment compared with just 22% of those without DI ( p = 0.026). Bilateral neck disease was more common in patients with DI (11/34, 32%) compared with those without (2/27, 7%) ( p = 0.018). Five-year regional recurrence-free survival rates were 88% for those without and 64% for those with DI ( p = 0.022). Kadish C patients with DI were more likely to develop regional recurrence when compared with Kadish C without DI and Kadish A/B ( p = 0.083). Further, Kadish C patients with DI displayed worse overall survival than Kadish C without DI and Kadish A/B. Kadish D patients displayed the worst overall survival. The difference in overall survival among these four groups was significant ( p < 0.001). Conclusion DI by ENB is associated with increased incidence of cervical nodal metastases, bilateral neck disease, worse regional recurrence-free survival, and poorer overall survival. These data support the division of Kadish C by DI status.

KW - dural invasion

KW - elective neck treatment

KW - esthesioneuroblastoma

KW - neck metastases

KW - olfactory neuroblastoma

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