Correlating the treatment outcome with tumor staging, grading, and various treatment modalities in patients with esthesioneuroblastoma

Shuchita Singh; Lavleen Singh; Richa Ranjan; Manoj Kumar Singh; Alok Thakar; Suresh Chandra Sharma

doi:10.4103/sajc.sajc_273_18

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ORIGINAL ARTICLE: Head and Neck Cancers

08 (

); 124-126

doi:

10.4103/sajc.sajc_273_18

Correlating the treatment outcome with tumor staging, grading, and various treatment modalities in patients with esthesioneuroblastoma

Shuchita Singh^1,, Lavleen Singh², Richa Ranjan², Manoj Kumar Singh², Alok Thakar¹, Suresh Chandra Sharma¹

1 Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi

2 Department of Pathology, All India Institute of Medical Sciences, New Delhi

*Corresponding author: Dr. Shuchita Singh. drshuch@yahoo.com

Published: 2020-12-21

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Abstract

Objective: Although till date no management protocol for esthesioneuroblastoma (ENB) has been standardized due to tumor rarity, still multimodality approach shows better treatment outcomes as compared to surgery alone. The objective of this study was to analyze the clinicopathological spectrum of ENB and to correlate treatment response with tumor staging, histopathological grading, and various treatment modalities. Materials and Methods: Twenty-one consecutive patients with biopsy-proven ENB were studied and evaluated for response to treatment in the form of complete tumor resolution. Results were analyzed and correlated with stage and grade of tumor and form of therapy received. Results: There was male preponderance (3.2:1) with age ranging between 7 and 63 years (median of 25 years). Survival rates significantly dropped with increasing tumor stage (63.6% in stages A and B vs. 30% in stages C and D) and grade (100% in Grades 1 and 2 vs. 31.25% in Grades 3 and 4). The recurrence rate was 80% in surgery alone group, which came down to 43.7% if surgery was supplemented with other modalities. In cases where multimodality treatment plan was used, endoscopic procedures fared equally as open surgical procedures. Conclusion: Hyam’s grade and Kadish stage are important prognostic indicators of treatment outcome, with survival rates dropping with increasing tumor stage and grade. Multimodality treatment protocols have improved the disease outcome, making endoscopic surgery equivalent to radical surgeries regarding result outcomes and giving other advantages such as better cosmesis, less treatment-related morbidities, decreased hospital stay, and better cost-effectiveness.

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References

Monteiro EM, Lopes MG, Santos ER, Diniz CV, Albuquerque AS, Monteiro AP, et al. Endoscopic treatment of esthesioneuroblastoma. Braz J Otorhinolaryngol 2011;77:171-7.
Berger L, Luc R, Richard D. L'esthesioneuroepitheliome olfactif. Bull Assoc Fr Etude Cancer 1924;13:410-21.
Thompson LD. Olfactory neuroblastoma. Head Neck Pathol 2009;3:252-9.
Dulguerov P, Allal AS, Calcaterra TC. Esthesioneuroblastoma: A meta-analysis and review. Lancet Oncol 2001;2:683-90.
Devaiah AK, Andreoli MT. Treatment of esthesioneuroblastoma: A 16-year meta-analysis of 361 patients. Laryngoscope 2009;119:1412-6.
Lund VJ, Howard D, Wei W, Spittle M. Olfactory neuroblastoma: Past, present, and future? Laryngoscope 2003;113:502-7.
Cullen MJ, Cusack DA, O'Briain DS, Devlin JB, Kehely A, Lyons TA, et al. Neurosecretion of arginine vasopressin by an olfactory neuroblastoma causing reversible syndrome of antidiuresis. Am J Med 1986;81:911-6.
Singh W, Ramage C, Best P, Angus B. Nasal neuroblastoma secreting vasopressin. A case report. Cancer 1980;45:961-6.
Maeda H, Tsuruya K, Yotsueda H, Taniguchi M, Tokumoto M, Hirakata H, et al. A case report of syndrome of inappropriate secretion of antidiuretic hormone with marked edema due to administration of hypertonic saline. Ther Apher Dial 2007;11:309-13.
Plasencia YL, Cortés MB, Arencibia DM, Dámaso TM, Contreras IL, Pino AO, et al. Esthesioneuroblastoma recurrence presenting as a syndrome of inappropriate antidiuretic hormone secretion. Head Neck 2006;28:1142-6.
al Ahwal M, Jha N, Nabholtz JM, Hugh J, Birchall I, Nguyen GK, et al. Olfactory neuroblastoma: Report of a case associated with inappropriate antidiuretic hormone secretion. J Otolaryngol 1994;23:437-9.
Freeman SR, Mitra S, Malik TH, Flanagan P, Selby P. Expression of somatostatin receptors in arginine vasopressin hormone-secreting olfactory neuroblastoma – Report of two cases. Rhinology 2005;43:61-5.
Srigley JR, Dayal VS, Gregor RT, Love R, van Nostrand AW. Hyponatremia secondary to olfactory neuroblastoma. Arch Otolaryngol 1983;109:559-62.
Osterman J, Calhoun A, Dunham M, Cullum UX Jr., Clark RM, Stewart DD, et al. Chronic syndrome of inappropriate antidiuretic hormone secretion and hypertension in a patient with olfactory neuroblastoma. Evidence of ectopic production of arginine vasopressin by the tumor. Arch Intern Med 1986;146:1731-5.
Rinaldo A, Ferlito A, Shaha AR, Wei WI, Lund VJ. Esthesioneuroblastoma and cervical lymph node metastases: Clinical and therapeutic implications. Acta Otolaryngol 2002;122:215-21.
Shaari CM, Catalano PJ, Sen C, Post K. Central nervous system metastases from esthesioneuroblastoma. Otolaryngol Head Neck Surg 1996;114:808-12.
Olsen KD, DeSanto LW. Olfactory neuroblastoma. Biologic and clinical behavior. Arch Otolaryngol 1983;109:797-802.
Beitler JJ, Fass DE, Brenner HA, Huvos A, Harrison LB, Leibel SA, et al. Esthesioneuroblastoma: Is there a role for elective neck treatment? Head Neck 1991;13:321-6.
Djalilian M, Zujko RD, Weiland LH, Devine KD. Olfactory neuroblastoma. Surg Clin North Am 1977;57:751-62.
Becker LE, Hinton D. Primitive neuroectodermal tumors of the central nervous system. Hum Pathol 1983;14:538-50.
Gore MR, Zanation AM. Salvage treatment of local recurrence in esthesioneuroblastoma: A Meta-analysis. Skull Base 2011;21:1-6.
Parsons JT, Mendenhall WM, Mancuso AA, Cassisi NJ, Million RR. Malignant tumors of the nasal cavity and ethmoid and sphenoid sinuses. Int J Radiat Oncol Biol Phys 1988;14:11-22.
Kadish S, Goodman M, Wang CC. Olfactory neuroblastoma. A clinical analysis of 17 cases. Cancer 1976;37:1571-6.
Elkon D, Hightower SI, Lim ML, Cantrell RW, Constable WC. Esthesioneuroblastoma. Cancer 1979;44:1087-94.
Simon JH, Zhen W, McCulloch TM, Hoffman HT, Paulino AC, Mayr NA, et al. Esthesioneuroblastoma: The university of Iowa experience 1978-1998. Laryngoscope 2001;111:488-93.
Cantrell RW, Ghorayeb BY, Fitz-Hugh GS. Esthesioneuroblastoma: Diagnosis and treatment. Ann Otol Rhinol Laryngol 1977;86:760-5.
Skolnik EM, Massari FS, Tenta LT. Olfactory neuroepithelioma. Review of the world literature and presentation of two cases. Arch Otolaryngol 1966;84:644-53.
Oberman HA, Rice DH. Olfactory neuroblastomas: A clinicopathologic study. Cancer 1976;38:2494-502.
Doyle PJ, Paxton HD. Combined surgical approach to esthesioneuroepithelioma. Trans Am Acad Ophthalmol Otolaryngol 1971;75:526-31.
Stammberger H, Anderhuber W, Walch C, Papaefthymiou G. Possibilities and limitations of endoscopic management of nasal and paranasal sinus malignancies. Acta Otorhinolaryngol Belg 1999;53:199-205.
Suriano M, De Vincentiis M, Colli A, Benfari G, Mascelli A, Gallo A, et al. Endoscopic treatment of esthesioneuroblastoma: A minimally invasive approach combined with radiation therapy. Otolaryngol Head Neck Surg 2007;136:104-7.
Eloy JA, Vivero RJ, Hoang K, Civantos FJ, Weed DT, Morcos JJ, et al. Comparison of transnasal endoscopic and open craniofacial resection for malignant tumors of the anterior skull base. Laryngoscope 2009;119:834-40.

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[1] Monteiro EM, Lopes MG, Santos ER, Diniz CV, Albuquerque AS, Monteiro AP, et al. Endoscopic treatment of esthesioneuroblastoma. Braz J Otorhinolaryngol 2011;77:171-7.

[2] Berger L, Luc R, Richard D. L'esthesioneuroepitheliome olfactif. Bull Assoc Fr Etude Cancer 1924;13:410-21.

[3] Thompson LD. Olfactory neuroblastoma. Head Neck Pathol 2009;3:252-9.

[4] Dulguerov P, Allal AS, Calcaterra TC. Esthesioneuroblastoma: A meta-analysis and review. Lancet Oncol 2001;2:683-90.

[5] Devaiah AK, Andreoli MT. Treatment of esthesioneuroblastoma: A 16-year meta-analysis of 361 patients. Laryngoscope 2009;119:1412-6.

[6] Lund VJ, Howard D, Wei W, Spittle M. Olfactory neuroblastoma: Past, present, and future? Laryngoscope 2003;113:502-7.

[7] Cullen MJ, Cusack DA, O'Briain DS, Devlin JB, Kehely A, Lyons TA, et al. Neurosecretion of arginine vasopressin by an olfactory neuroblastoma causing reversible syndrome of antidiuresis. Am J Med 1986;81:911-6.

[8] Singh W, Ramage C, Best P, Angus B. Nasal neuroblastoma secreting vasopressin. A case report. Cancer 1980;45:961-6.

[9] Maeda H, Tsuruya K, Yotsueda H, Taniguchi M, Tokumoto M, Hirakata H, et al. A case report of syndrome of inappropriate secretion of antidiuretic hormone with marked edema due to administration of hypertonic saline. Ther Apher Dial 2007;11:309-13.

[10] Plasencia YL, Cortés MB, Arencibia DM, Dámaso TM, Contreras IL, Pino AO, et al. Esthesioneuroblastoma recurrence presenting as a syndrome of inappropriate antidiuretic hormone secretion. Head Neck 2006;28:1142-6.

[11] al Ahwal M, Jha N, Nabholtz JM, Hugh J, Birchall I, Nguyen GK, et al. Olfactory neuroblastoma: Report of a case associated with inappropriate antidiuretic hormone secretion. J Otolaryngol 1994;23:437-9.

[12] Freeman SR, Mitra S, Malik TH, Flanagan P, Selby P. Expression of somatostatin receptors in arginine vasopressin hormone-secreting olfactory neuroblastoma – Report of two cases. Rhinology 2005;43:61-5.

[13] Srigley JR, Dayal VS, Gregor RT, Love R, van Nostrand AW. Hyponatremia secondary to olfactory neuroblastoma. Arch Otolaryngol 1983;109:559-62.

[14] Osterman J, Calhoun A, Dunham M, Cullum UX Jr., Clark RM, Stewart DD, et al. Chronic syndrome of inappropriate antidiuretic hormone secretion and hypertension in a patient with olfactory neuroblastoma. Evidence of ectopic production of arginine vasopressin by the tumor. Arch Intern Med 1986;146:1731-5.

[15] Rinaldo A, Ferlito A, Shaha AR, Wei WI, Lund VJ. Esthesioneuroblastoma and cervical lymph node metastases: Clinical and therapeutic implications. Acta Otolaryngol 2002;122:215-21.

[16] Shaari CM, Catalano PJ, Sen C, Post K. Central nervous system metastases from esthesioneuroblastoma. Otolaryngol Head Neck Surg 1996;114:808-12.

[17] Olsen KD, DeSanto LW. Olfactory neuroblastoma. Biologic and clinical behavior. Arch Otolaryngol 1983;109:797-802.

[18] Beitler JJ, Fass DE, Brenner HA, Huvos A, Harrison LB, Leibel SA, et al. Esthesioneuroblastoma: Is there a role for elective neck treatment? Head Neck 1991;13:321-6.

[19] Djalilian M, Zujko RD, Weiland LH, Devine KD. Olfactory neuroblastoma. Surg Clin North Am 1977;57:751-62.

[20] Becker LE, Hinton D. Primitive neuroectodermal tumors of the central nervous system. Hum Pathol 1983;14:538-50.

[21] Gore MR, Zanation AM. Salvage treatment of local recurrence in esthesioneuroblastoma: A Meta-analysis. Skull Base 2011;21:1-6.

[22] Parsons JT, Mendenhall WM, Mancuso AA, Cassisi NJ, Million RR. Malignant tumors of the nasal cavity and ethmoid and sphenoid sinuses. Int J Radiat Oncol Biol Phys 1988;14:11-22.

[23] Kadish S, Goodman M, Wang CC. Olfactory neuroblastoma. A clinical analysis of 17 cases. Cancer 1976;37:1571-6.

[24] Elkon D, Hightower SI, Lim ML, Cantrell RW, Constable WC. Esthesioneuroblastoma. Cancer 1979;44:1087-94.

[25] Simon JH, Zhen W, McCulloch TM, Hoffman HT, Paulino AC, Mayr NA, et al. Esthesioneuroblastoma: The university of Iowa experience 1978-1998. Laryngoscope 2001;111:488-93.

[26] Cantrell RW, Ghorayeb BY, Fitz-Hugh GS. Esthesioneuroblastoma: Diagnosis and treatment. Ann Otol Rhinol Laryngol 1977;86:760-5.

[27] Skolnik EM, Massari FS, Tenta LT. Olfactory neuroepithelioma. Review of the world literature and presentation of two cases. Arch Otolaryngol 1966;84:644-53.

[28] Oberman HA, Rice DH. Olfactory neuroblastomas: A clinicopathologic study. Cancer 1976;38:2494-502.

[29] Doyle PJ, Paxton HD. Combined surgical approach to esthesioneuroepithelioma. Trans Am Acad Ophthalmol Otolaryngol 1971;75:526-31.

[30] Stammberger H, Anderhuber W, Walch C, Papaefthymiou G. Possibilities and limitations of endoscopic management of nasal and paranasal sinus malignancies. Acta Otorhinolaryngol Belg 1999;53:199-205.

[31] Suriano M, De Vincentiis M, Colli A, Benfari G, Mascelli A, Gallo A, et al. Endoscopic treatment of esthesioneuroblastoma: A minimally invasive approach combined with radiation therapy. Otolaryngol Head Neck Surg 2007;136:104-7.

[32] Eloy JA, Vivero RJ, Hoang K, Civantos FJ, Weed DT, Morcos JJ, et al. Comparison of transnasal endoscopic and open craniofacial resection for malignant tumors of the anterior skull base. Laryngoscope 2009;119:834-40.

Correlating the treatment outcome with tumor staging, grading, and various treatment modalities in patients with esthesioneuroblastoma

Abstract

Abstract

Keywords

References

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