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

Kevin C. Miller, John P. Marinelli, Jeffrey R. Janus, Ashish V. Chintakuntlawar, Robert Foote, Michael Link, Garret Choby, Jamie J. Van Gompel

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)E131-E137
JournalJournal of Neurological Surgery, Part B: Skull Base
Volume82
DOIs
StatePublished - Jul 1 2021

Keywords

  • esthesioneuroblastoma
  • induction
  • neoadjuvant
  • outcomes
  • therapy

ASJC Scopus subject areas

  • Clinical Neurology

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