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

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.

Keywords

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

• References

• 1 Dulguerov P, Allal AS, Calcaterra TC. Esthesioneuroblastoma: a meta-analysis and review. Lancet Oncol 2001; 2 (11) 683-690
• 2 Broich G, Pagliari A, Ottaviani F. Esthesioneuroblastoma: a general review of the cases published since the discovery of the tumour in 1924. Anticancer Res 1997; 17 (4A): 2683-2706
• 3 De Bonnecaze G, Lepage B, Rimmer J. , et al. Long-term carcinologic results of advanced esthesioneuroblastoma: a systematic review. Eur Arch Otorhinolaryngol 2016; 273 (01) 21-26
• 4 Jethanamest D, Morris LG, Sikora AG, Kutler DI. Esthesioneuroblastoma: a population-based analysis of survival and prognostic factors. Arch Otolaryngol Head Neck Surg 2007; 133 (03) 276-280
• 5 Naples JG, Spiro J, Tessema B, Kuwada C, Kuo CL, Brown SM. Neck recurrence and mortality in esthesioneuroblastoma: Implications for management of the N0 neck. Laryngoscope 2016; 126 (06) 1373-1379
• 6 Louveau A, Smirnov I, Keyes TJ. , et al. Structural and functional features of central nervous system lymphatic vessels. Nature 2015; 523 (7560): 337-341
• 7 Aspelund A, Antila S, Proulx ST. , et al. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules. J Exp Med 2015; 212 (07) 991-999
• 8 Hyams VJ, Batsakis JG, Michaels L. , et al. Tumors of the Upper Respiratory Tract and Ear. Washington, DC: Armed Forces Institute of Pathology: Supt. of Docs., U.S. G.P.O. For sale by the Armed Forces Institute of Pathology; 1988. :343.
• 9 Morita A, Ebersold MJ, Olsen KD, Foote RL, Lewis JE, Quast LM. Esthesioneuroblastoma: prognosis and management. Neurosurgery 1993; 32 (05) 706-714 , discussion 714–715
• 10 Nalavenkata SB, Sacks R, Adappa ND. , et al. Olfactory neuroblastoma: fate of the neck--a long-term multicenter retrospective study. Otolaryngol Head Neck Surg 2016; 154 (02) 383-389
• 11 Dulguerov P, Calcaterra T. Esthesioneuroblastoma: the UCLA experience 1970-1990. Laryngoscope 1992; 102 (08) 843-849
• 12 Tajudeen BA, Arshi A, Suh JD. , et al. Esthesioneuroblastoma: an update on the UCLA experience, 2002-2013. J Neurol Surg B Skull Base 2015; 76 (01) 43-49
• 13 Malouf GG, Casiraghi O, Deutsch E, Guigay J, Temam S, Bourhis J. Low- and high-grade esthesioneuroblastomas display a distinct natural history and outcome. Eur J Cancer 2013; 49 (06) 1324-1334
• 14 Van Gompel JJ, Giannini C, Olsen KD. , et al. Long-term outcome of esthesioneuroblastoma: hyams grade predicts patient survival. J Neurol Surg B Skull Base 2012; 73 (05) 331-336
• 15 Demiroz C, Gutfeld O, Aboziada M, Brown D, Marentette LJ, Eisbruch A. Esthesioneuroblastoma: is there a need for elective neck treatment?. Int J Radiat Oncol Biol Phys 2011; 81 (04) e255 –e261
• 16 Jiang W, Mohamed AS, Fuller CD. , et al. The role of elective nodal irradiation for esthesioneuroblastoma patients with clinically negative neck. Pract Radiat Oncol 2016; 6 (04) 241-247
• 17 Monroe AT, Hinerman RW, Amdur RJ, Morris CG, Mendenhall WM. Radiation therapy for esthesioneuroblastoma: rationale for elective neck irradiation. Head Neck 2003; 25 (07) 529-534
• 18 Yin ZZ, Luo JW, Gao L. , et al. Spread patterns of lymph nodes and the value of elective neck irradiation for esthesioneuroblastoma. Radiother Oncol 2015; 117 (02) 328-332
• 19 Banuchi VE, Dooley L, Lee NY. , et al. Patterns of regional and distant metastasis in esthesioneuroblastoma. Laryngoscope 2016; 126 (07) 1556-1561
• 20 Marinelli JP, Van Gompel JJ, Link MJ. , et al. Volumetric analysis of olfactory neuroblastoma skull base laterality and implications on neck disease. Laryngoscope 2017