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
