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Husain Q, Kanumuri VV, Svider PF, Radvansky BM, Boghani Z, Liu JK, Eloy JA. Sinonasal Adenoid Cystic Carcinoma. Otolaryngol Head Neck Surg 2012; 148:29-39. [DOI: 10.1177/0194599812464020] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objective This study reviews the published outcomes related to sinonasal adenoid cystic carcinoma (SNACC). Clinical presentation, radiographic diagnosis, pathology, treatment, and management outcomes of this uncommon disease are reported. Data Sources PubMed database. Methods A systematic review of studies for SNACC from 1960 to 2012 was conducted. A PubMed search for articles related to SNACC, along with bibliographies of those articles, was performed. Articles were examined for both individual patient data (IPD) and aggregate patient data (APD) that reported survivability. Demographics, disease site and spread, treatment strategies, follow-up, outcome, and survival were described for IPD, and a meta-analysis for survival rates was performed for APD. Results A total of 55 journal articles were included. Individual patient data were reported in 39 journal articles, comprising a total of 88 cases of SNACC. Sixteen articles, totaling 366 patients that reported aggregate 5-year survivorship pertaining to SNACC, were also included. Average follow-up in the IPD was 51.2 months (range, 1-198 months), and 5-year survivorship was 63.5%. In the studies reviewed, surgery followed by postoperative radiotherapy was the most common therapy used and resulted in the highest percentage of survivors. Aggregate patient data meta-analysis revealed a 5-year survival rate of 62.5%. Conclusion This study contains the largest pool of SNACC patients to date. The data suggest that SNACC has a poor overall prognosis. It also suggests that surgery with postoperative radiotherapy is the most commonly used and may possibly be the most effective therapy.
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Affiliation(s)
- Qasim Husain
- Department of Otolaryngology–Head & Neck Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey, USA
| | - Vivek V. Kanumuri
- Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey, USA
| | - Peter F. Svider
- Department of Otolaryngology–Head & Neck Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey, USA
| | - Brian M. Radvansky
- Department of Otolaryngology–Head & Neck Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey, USA
| | - Zain Boghani
- Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey, USA
| | - James K. Liu
- Department of Otolaryngology–Head & Neck Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey, USA
- Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey, USA
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology–Head & Neck Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey, USA
- Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey, USA
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey, USA
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Obeyesekere MN, Leong-Sit P, Krahn AD, Gula LJ, Yee R, Skanes AC, Klein GJ. Asymptomatic Wolff-Parkinson-White Syndrome: Who Should Be Treated? Card Electrophysiol Clin 2012; 4:273-280. [PMID: 26939946 DOI: 10.1016/j.ccep.2012.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article discusses the merits of electrophysiology study (EPS) and/or ablation for asymptomatic preexcitation Wolff-Parkinson-White (WPW) ECG pattern. Sudden deaths in asymptomatic patients are too few to merit broad screening and aggressive intervention. It also discusses the risks of ablation and the low predictive accuracy of EPS. When WPW is an incidental finding, the decision to proceed with investigation and ablation can be made considering patients' situations and preferences. An invasive strategy is targeted at patients concerned about the low risk of life-threatening arrhythmia as a first presentation after a discussion of the risks and benefits.
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Affiliation(s)
- Manoj N Obeyesekere
- Division of Cardiology, Western University, 339 Windermere Road, C6-110, London, Ontario N6A 5A5, Canada
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Obeyesekere MN, Leong-Sit P, Massel D, Manlucu J, Krahn AD, Skanes AC, Yee R, Gula LJ, Klein GJ. Incidence of atrial fibrillation and prevalence of intermittent pre-excitation in asymptomatic Wolff–Parkinson–White patients: A meta-analysis. Int J Cardiol 2012; 160:75-7. [DOI: 10.1016/j.ijcard.2012.05.078] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Revised: 05/25/2012] [Accepted: 05/27/2012] [Indexed: 11/15/2022]
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Pappone C, Santinelli V. Asymptomatic Wolff-Parkinson-White Syndrome Should be Ablated. Card Electrophysiol Clin 2012; 4:281-285. [PMID: 26939947 DOI: 10.1016/j.ccep.2012.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Wolff-Parkinson-White syndrome (WPW) is associated with a small but lifetime risk of cardiac arrest and/or sudden cardiac death (SCD). However, the exact risk is not well defined, particularly in asymptomatic persons. Over recent years the authors have collected and reported new follow-up data among a large number of asymptomatic WPW patients, particularly children, intensively followed. These data have significantly contributed to the knowledge and definition of the natural history of WPW from childhood to adulthood. The risk of SCD is higher in asymptomatic children than in adults, and early ablation can be offered only to selected subjects after electrophysiologic testing.
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Affiliation(s)
- Carlo Pappone
- Arrhythmology Department, Maria Cecilia Hospital, Via Corriera 1, 48010 Cotignola, Italy
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