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Kazemian A, Farazmand B, Taherioun M, Razmkhah M, Shirkhoda M, Jalaeefar A, Garajei A, Jafari M, Heidari F, Aghili M, Ghalehtaki R. The role of histology on the outcome of sinonasal carcinomas treated with radiotherapy: a single institution experience. Radiat Oncol J 2024; 42:116-123. [PMID: 38946073 PMCID: PMC11215502 DOI: 10.3857/roj.2022.00514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/20/2023] [Accepted: 12/01/2023] [Indexed: 07/02/2024] Open
Abstract
PURPOSE Sinonasal malignancies are a rare group of head and neck cancers. We aimed to report the oncological outcomes based on histological types in patients who underwent radiotherapy. MATERIALS AND METHODS In this single-institution study, we retrospectively retrieved and analyzed data of patients with sinonasal carcinomas who underwent radiotherapy during 2011-2016 as part of their treatment. The 3-year rate of local, regional, and distant recurrences, and overall survival were evaluated according to the histological type. RESULTS A total of 28 patients were evaluated in this study, the majority of whom were male (60%). Squamous cell carcinoma (SCC), adenoid cystic carcinoma (ACC), and adenocarcinoma (ADC) were found in 15 patients (53.5%), 8 (28.5%), and 5 (18%), respectively. The highest rates of local and regional recurrences were observed in ACC and SCC, respectively. Distant recurrences were numerically more common in ADC. The 3-year OS was 48%, 50%, and 73% in SCC, ADC, and ACC, respectively. CONCLUSION Different histopathologies of sinonasal cancer seem to have different patterns of failure, and this may be considered in the treatment approach.
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Affiliation(s)
- Ali Kazemian
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
- Radiation Oncology Research Center, Cancer Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Borna Farazmand
- Radiation Oncology Research Center, Cancer Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Taherioun
- Department of Radiation Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdie Razmkhah
- Department of Radiation Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shirkhoda
- Department of Oncosurgery, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirmohsen Jalaeefar
- Department of Oncosurgery, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ata Garajei
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Jafari
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Farrokh Heidari
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Aghili
- Radiation Oncology Research Center, Cancer Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiation Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Ghalehtaki
- Radiation Oncology Research Center, Cancer Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiation Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
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Liu Q, Sun M, Wang Z, Qu Y, Zhang J, Wang K, Wu R, Zhang Y, Huang X, Chen X, Wang J, Xiao J, Yi J, Xu G, Luo J. Failure Patterns Within Different Histological Types in Sinonasal Malignancies: Making the Complex Simple. Otolaryngol Head Neck Surg 2023; 169:1513-1522. [PMID: 37727935 DOI: 10.1002/ohn.527] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/11/2023] [Accepted: 07/14/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE To analyze the failure patterns in patients with different histological subtypes of sinonasal malignancies (SNMs). STUDY DESIGN Retrospectively gathered data. SETTING Academic university hospital. METHODS Patients with SNMs treated at a tertiary referral center between January 1999 and January 2019 were included. We assessed the failure patterns within different histological subtypes. RESULTS The study included 897 patients. The median follow-up time was 100 months. Adenoid cystic carcinoma (ACC) had a moderate risk of developing local recurrence (LR) and distant metastasis (DM). Compared with ACC, squamous cell carcinoma (SCC), adenocarcinoma (AC), soft tissue sarcoma (STS), and mucosal melanoma (MM) were classified as a high LR risk group. For DM, neuroendocrine carcinoma (NEC), STS, and MM were in the high-risk group. CONCLUSIONS ACC had intermediate local and distant failure risks, while SCC, AC, STS, and MM were at high LR risks. NEC, STS, and MM were at high DM risk.
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Affiliation(s)
- Qian Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meng Sun
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zekun Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Qu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianghu Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kai Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Runye Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaodong Huang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuesong Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingbo Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianping Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junlin Yi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guozhen Xu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingwei Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Saha S, Patil VM, Noronha V, Menon N, Singh AK, Suman M, Agrawal A, Khaddar S, Chakraborty S, Pai PS, Chaukar DA, Chaturvedi P, Laskar SG, Prabhash K. Neoadjuvant chemotherapy in a rare type of very locally advanced sinonasal carcinomas - long-term results from a tertiary care centre. Ecancermedicalscience 2023; 17:1549. [PMID: 37377683 PMCID: PMC10292851 DOI: 10.3332/ecancer.2023.1549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Indexed: 06/29/2023] Open
Abstract
Introduction Sinonasal carcinomas are a rare type of head and neck malignancy with various histologies. The outcomes of patients with unresectable locally advanced sinonasal carcinomas are poor. Hence, we performed this analysis to study the long-term outcomes of sinonasal adenocarcinoma (SNAC) and sinonasal undifferentiated carcinomas (SNUC) where neoadjuvant chemotherapy (NACT) has been given followed by local therapy. Methods 16 patients with SNUC and adenocarcinoma who received NACT were found eligible for the study. Descriptive statistical analysis was performed for baseline characteristics, adverse events and treatment compliance. Kaplan Meir methods were used for the estimation of progression-free survival (PFS) and overall survival (OS). Results Seven (43.75%) adenocarcinoma and nine (56.25%) SNUC patients were identified. The median age of the whole cohort was 48.5 years. The median number of cycles delivered was 3 (IQR 1-8). The incidence of grade 3-4 toxicity (CTCAE version 5.0) was 18.75%. The response was partial response or better in seven patients (43.75%). Post-NACT 11 patients (n = 15, 73%) were eligible for definitive therapy. The median PFS was 7.63 months (95% CI, 3.23 - NA months) and the median OS was 10.6 months (95% CI, 5.2-51.5 months). Median PFS and OS for those who underwent surgery post-NACT versus those who did not undergo surgery were 36.267 versus 3.7 months (p = 0.012) and 51.5 versus 10.633 months (p = 0.190), respectively. Conclusion The study shows a favourable role of NACT in improving resectability, significant improvement in PFS and non-significant improvement in OS after surgery.
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Affiliation(s)
- Saswata Saha
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
- Both the authors contributed equally and to be considered as first author
| | - Vijay M Patil
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
- Both the authors contributed equally and to be considered as first author
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
| | - Nandini Menon
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
| | - Ajay Kumar Singh
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
| | - Mannavi Suman
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
| | - Amit Agrawal
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
| | - Satvik Khaddar
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
| | - Shatabdi Chakraborty
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
| | - Prathamesh S Pai
- Department of Head and Neck Surgery, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
| | - Devendra A Chaukar
- Department of Head and Neck Surgery, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
| | - Pankaj Chaturvedi
- Department of Head and Neck Surgery, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
| | - Sarbani Ghosh Laskar
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, Maharashtra, India
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Kong KA, Thorp BD, Sheth SH. The Role of Induction Therapy for Sinonasal Cancers. Curr Treat Options Oncol 2023; 24:162-169. [PMID: 36696082 DOI: 10.1007/s11864-022-01046-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 01/26/2023]
Abstract
OPINION STATEMENT The role of induction chemotherapy in sinonasal cancers is promising; however, prospective studies with higher grades of evidence are needed. With the currently available literature, the authors would advocate for the use of induction chemotherapy (IC) in locally advanced sinonasal squamous cell carcinoma (T3-T4) for organ preservation and potentially for improved survival outcomes. In sinonasal undifferentiated carcinoma (SNUC), IC should be considered in all patients given its tendency for aggressive invasion and poor outcomes. In SNUC, response to IC may direct the modality of definitive treatment to follow. In responders (partial or complete), chemoradiation therapy should be strongly considered. In non-responders or in those with progression of disease, surgical therapy is favored. For esthesioneuroblastoma, surgical resection with negative margins and adjuvant radiation therapy remains the gold standard. However, IC may be considered for locally advanced disease especially with orbital invasion or in recurrent/distant disease. There is no definite indication for IC in sinonasal adenoid cystic carcinoma or sinonasal adenocarcinoma. Recommendations are summarized in Table 1.
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Affiliation(s)
- Keonho A Kong
- Department of Otolaryngology/Head & Neck Surgery, University of Mississippi Medical Center, Jackson, USA
| | - Brian D Thorp
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina, Chapel Hill, USA
| | - Siddharth H Sheth
- Division of Oncology, Department of Medicine, University of North Carolina, Houpt Building, 3rd Floor, 170 Manning Drive, CB# 7305, Chapel Hill, NC, 27599, USA.
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Li G, Shi Y, Liu Q, Zhang H, Xue K, Song X, Gu Y, Sun X, Dai Q, Yu H. Sinonasal intestinal- and non-intestinal-type adenocarcinoma in China: a retrospective study of 14 cases. Acta Otolaryngol 2023; 143:185-190. [PMID: 36780311 DOI: 10.1080/00016489.2023.2175032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND In China, reports on the epidemiology of adenocarcinomas of the nasal cavity and paranasal sinuses are limited. AIM This study aimed to describe the experience of a single institution in China in treating these malignant tumours. MATERIALS AND METHODS We conducted a retrospective chart review of patients with adenocarcinoma of the nasal cavity and paranasal sinuses admitted between January 2019 and December 2021. Tumour staging was based on the American Joint Committee on Cancer, 8th edition, for sinonasal malignancies. RESULTS The series included 10 men and 4 women (mean age, 54.5 [range, 14-80] years). Epistaxis and nasal obstruction were the most common clinical manifestations in 10 (71.4%) patients. Ten (71.4%) had stage T4 disease at diagnosis, but no patient had lymph node or distant metastasis. The posterosuperior septum (100.0%) and middle turbinate (92.8%) were the two sites most vulnerable to tumour invasion. All patients underwent endoscopic resection as the initial treatment; one patient died. CONCLUSIONS AND SIGNIFICANCE In China, these malignancies are related to exposure to certain substances; however, diagnosis can be delayed. Endoscopic resection is a suitable treatment option for adenocarcinomas of the nasal cavity and paranasal sinuses.
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Affiliation(s)
- Guangyao Li
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, PR China
| | - Yuxuan Shi
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, PR China
| | - Quan Liu
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, PR China
| | - Huankang Zhang
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, PR China
| | - Kai Xue
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, PR China
| | - Xiaole Song
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, PR China
| | - Ye Gu
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, PR China
| | - Xicai Sun
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, PR China
| | - Qi Dai
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, PR China
| | - Hongmeng Yu
- Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, PR China.,Research Units of New Technologies of Endoscopic Surgery in Skull Base Tumor (2018RU003), Chinese Academy of Medical Sciences, Beijing, PR China
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Updates in management strategies of locally advanced sinonasal malignancy. Curr Opin Otolaryngol Head Neck Surg 2023; 31:39-44. [PMID: 36856185 DOI: 10.1097/moo.0000000000000866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
PURPOSE OF REVIEW Sinonasal tumors are a rare heterogenous group of pathologies with poor prognosis. In recent years better definition and understanding of histology, molecular classification, biological behavior and advances in therapy have resulted in improved prognosis. The purpose of this review is to give an updated summary of the recent advances in treatment, and where relevant, with references to pathology classifications. RECENT FINDINGS Recent publications highlight the role of induction chemotherapy and advances in radiotherapy in advanced cancers. In addition, better understanding of genomics and histology specific treatment algorithms has led to more tailored treatment approaches. The role of immunotherapy and targeted therapy are yet to be explored. SUMMARY This review gives an up to date summary of the advances in contemporary management strategies for locally advanced sinonasal malignancies and can serve as a guide for researchers and clinicians.
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Multicenter study to assess surgical treatments of 452 sinonasal intestinal-type adenocarcinomas: A REFCOR study. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:39-46. [PMID: 35995650 DOI: 10.1016/j.ejso.2022.07.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/11/2022] [Accepted: 07/24/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE The objective was to assess the local oncological outcomes of endoscopic versus external surgical treatment of sinonasal intestinal-type adenocarcinomas (ITAC) and the factors of recurrence. METHODS a retrospective non-randomized case-control multicenter study was carried out, including 452 untreated sinonasal ITACs recruited from 10 tertiary referral centers. The tumors were re-classified according to the UICC 2017 (pT). Survival curves were obtained using the Kaplan-Meier method. Univariate analysis was done with the log-rank test. Multivariate analysis was performed with a Cox model adjusted for age, T stage, and radiotherapy. A binary logistic regression compared surgical complications and performed two supplementary analyses on positive margins. RESULTS We compared 195 and 257 patients operated by the external and endoscopic approach, respectively. The mean follow-up was 59.2 ± 48.7 months. Post-operative margins were invaded in 30.6 versus 18.9% of patients, respectively (p = 0.007). The overall recurrence rate was 33.8 versus 24.6%, respectively (p = 0.034). There was a significant difference in favor of the endoscopic approach regarding local recurrence-free survival thanks to better surgical margins in univariate and multivariate analysis (Odd Ratio = 2.01 (1.2-3.36) p = 0.0087). The complication rate (Odds Ratio = 3.4 (1.79-6.32) p < 0.001) was significantly lower in the endoscopic group. The histological positivity of signet-ring cells shows a statistically significant difference in recurrence-free survival (p = 0.0028). CONCLUSION the oncological control of ITAC is better through the endoscopic approach, with negative margins and the absence of signet-ring-cells, two independent factors of recurrence.
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Sacks PL, Alvarado R, Sacks R, Kalish L, Campbell R, Harvey R. Prognostic factors and outcomes in minimal access resections of skull base and sinonasal epithelial malignancy. ANZ J Surg 2022; 92:3253-3258. [PMID: 36069324 DOI: 10.1111/ans.18022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Sinonasal epithelial malignancies are uncommon tumours but represent a challenge to treatment given their close proximity to the orbit, brain and cranial nerves. Traditional external surgical approaches have potential for significant functional and cosmetic morbidity. An endoscopic approach provides the surgeon with good access for tumour removal and enables surveillance postoperatively. This study aimed to assess outcomes of an endoscopic approach to sinonasal epithelial malignancy and evaluate factors that may influence its utility. METHODS A case series was performed involving consecutive patients treated with endoscopic or endoscopic-assisted surgery for epithelial sinonasal malignancy. Stratification included TNM staging, histopathology, surgical approach, margin status, perineural involvement and adjuvant or neoadjuvant therapy. At follow-up, complications, local control, nodal status and evidence of distant metastases were recorded. Statistical analyses to identify risk factors for developing recurrence and survival differences were performed. RESULTS Thirty-five patients were assessed in this study (59.2 ± 11.4 years, 42.9% female). T stage at presentation was T1 in 11.4%, T2 in 17.1%, T3 in 22.9% and T4 in 48.6%. The 3 and 5 year disease specific survival were 91.3% (SE 5) and 71.1% (SE 10). The only factors to influence survival outcomes were perineural invasion of tumour and positive margins at the time of initial surgery. Large tumours did not limit the utility of an endoscopic approach. CONCLUSION Endoscopic approach is a safe and oncologically equitable treatment approach to external approaches in the management of epithelial sinonasal malignancy. As with external approaches, perineural invasion of malignance is a poor prognostic factor.
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Affiliation(s)
- Peta-Lee Sacks
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Raquel Alvarado
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Raymond Sacks
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
- The University of Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Department of Otolaryngology, Concord General Hospital, Sydney, New South Wales, Australia
| | - Larry Kalish
- The University of Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Department of Otolaryngology, Concord General Hospital, Sydney, New South Wales, Australia
| | - Raewyn Campbell
- Department of Otolaryngology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Richard Harvey
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
- Department of Otolaryngology/Skull Base Surgery, St Vincent's Hospital, Sydney, New South Wales, Australia
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Huang H, Chen K, Deng L, Chen Y, Zhao D, Lin W. Development and validation of a nomogram for prognosis of sinonasal adenocarcinoma (a nomogram for sinonasal adenocarcinoma). Jpn J Clin Oncol 2022; 52:869-879. [PMID: 35642571 DOI: 10.1093/jjco/hyac083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The incidence of sinonasal adenocarcinoma is low, and there are few studies on survival and prognosis. Therefore, we aim to develop and validate a prognostic model for predicting the overall survival of sinonasal adenocarcinoma and provide guidance for clinical management. METHODS Patients who were diagnosed as sinonasal adenocarcinoma through Surveillance, Epidemiology, and End Results database between 1975 and 2015 were randomly divided into a training group and validation group. Univariate, multivariate survival analysis was performed to screen independent survival factors. A nomogram was established to predict the overall survival rate of sinonasal adenocarcinoma. Receiver operating characteristic curve and calibration plot were performed to verify the discrimination and accuracy of the model. A decision curve analysis was performed to verify the clinical applicability of the model. RESULTS A total of 423 patients with sinonasal adenocarcinoma were randomly divided into training group (n = 299) and verification group (n = 124). We established and verified the Nomo map including age, marriage, grade, surgery and tumour size. The c-index of Surveillance, Epidemiology, and End Results stage, T stage and this model are 0.635, 0.626 and 0.803, respectively. The survival rate of the high-risk group scored by this model was lower than that of the low-risk group (P < 0.001). Decision curve analysis shows that the model has advantages in predicting survival rates. CONCLUSION Our model is considered to be a useful tool for predicting the overall survival of sinonasal adenocarcinoma, with good discrimination and clinical applicability. We hope that this model will help rhinologists to make clinical decisions and manage patients diagnosed with sinonasal adenocarcinoma.
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Affiliation(s)
- Hesen Huang
- Department of Otolaryngology-Head and Neck Surgery, Xiang'an Hospital of Xiamen University, Xia Men, Fu Jian, China
| | - Kaiqin Chen
- Department of Neurosurgery, Xiang'an Hospital of Xiamen University, Xia Men, Fu Jian, China
| | - Lifeng Deng
- Quanzhou Medical College, Quanzhou, Fujian, China
| | - Yaling Chen
- Department of Otolaryngology-Head and Neck Surgery, Xiang'an Hospital of Xiamen University, Xia Men, Fu Jian, China
| | - Dean Zhao
- Department of Otolaryngology-Head and Neck Surgery, Xiang'an Hospital of Xiamen University, Xia Men, Fu Jian, China
| | - Wei Lin
- Department of Otorhinolaryngology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
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Fierens S, Moya-Plana A, Vergez S, Bénard A, Gallard R, Molinier-Blossier S, Castain C, Orsel S, Verillaud B, Mortuaire G, de Gabory L. Do practitioners assess sinonasal adenocarcinoma extension similarly? Interdisciplinary concordance in 21 cases. Clin Otolaryngol 2021; 46:665-669. [PMID: 33377291 DOI: 10.1111/coa.13708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 11/18/2020] [Accepted: 12/20/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Sylvestre Fierens
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, France
| | - Antoine Moya-Plana
- Department of Otorhinolaryngology-Head and Neck Surgery, Gustave Roussy Cancer Center, Villejuif, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Toulouse, Toulouse, France
| | - Antoine Bénard
- Pôle de Santé Publique, Clinical Epidemiology Unit (USMR), Bordeaux, France
| | - Romain Gallard
- Pôle de Santé Publique, Clinical Epidemiology Unit (USMR), Bordeaux, France
| | | | - Claire Castain
- Department of Pathology, University Hospital of Bordeaux, Bordeaux, France
| | - Stephane Orsel
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Limoges, Limoges, France
| | - Benjamin Verillaud
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Lariboisière, Paris, France
| | - Geoffrey Mortuaire
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Lille, Lille, France
| | - Ludovic de Gabory
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, France.,University of Bordeaux, Bordeaux, France
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Chweya CM, Low CM, Van Gompel JJ, Van Abel KM, Stokken JK, Choby G. Population-based analysis on the effect of nodal and distant metastases in sinonasal adenocarcinoma. Head Neck 2020; 43:128-136. [PMID: 32929799 DOI: 10.1002/hed.26457] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/19/2020] [Accepted: 08/26/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Minimal information has been reported on the effect of distant and nodal metastases at the time of diagnosis on survival in patients with sinonasal adenocarcinoma (SNAC). METHODS The Surveillance, Epidemiology, and End Results database was utilized to compare overall survival (OS) and disease-specific survival (DSS). RESULTS Of the 325 patients with SNAC identified, 5-year and 10-year OS for all included patients was 64% and 58%, respectively. On multivariate analysis, the presence of distant metastases (P < .0001), maxillary and frontal sinus primary tumors (P = .0042, P = .0006), and increasing age (P = .007) were risk factors for worsened DSS. The presence of regional spread to multiple cervical nodal basins (OS RR 3.26, P = .002; DSS RR 2.51, P = .013) and a single nodal basin (DSS RR 2.19, P = .046) was associated with worsened survival compared to no regional spread. CONCLUSION Survival in SNAC was significantly worsened with increasing age, tumor site of origin, and distant metastatic disease.
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Affiliation(s)
| | - Christopher M Low
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Jamie J Van Gompel
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Kathryn M Van Abel
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Janalee K Stokken
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Garret Choby
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
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12
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Patel NN, Maina IW, Kuan EC, Triantafillou V, Trope MA, Carey RM, Workman AD, Tong CC, Kohanski MA, Palmer JN, Adappa ND, Newman JG, Brant JA. Adenocarcinoma of the Sinonasal Tract: A Review of the National Cancer Database. J Neurol Surg B Skull Base 2019; 81:701-708. [PMID: 33381376 DOI: 10.1055/s-0039-1696707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 07/28/2019] [Indexed: 12/13/2022] Open
Abstract
Background Sinonasal adenocarcinoma (SNAC) is a rare malignancy arising from mucus-secreting glandular tissue. Limited large-scale studies are available due to its rarity. We evaluated SNAC in the National Cancer Database (NCDB), a source that affords multi-institutional, population studies of rare cancers and their outcomes. Methods The NCDB was queried for adenocarcinoma in the sinonasal tract. Multivariate analyses were performed to evaluate for factors contributing to overall survival (OS). Results A total of 553 patients were identified. The cohort was composed of 59.3% males. The nasal cavity was the most common primary site, representing 44.1% of cases. About 5.7% of patients presented with nodal disease, while 3.3% had distant metastases. About 40.6% of cases presented with stage IV disease. About 73.5% of patients underwent surgery, 54.2% received radiation therapy, and 27.7% had chemotherapy. Median OS was 71.7 months, while OS at 1, 2, and 5 years was 82, 73.0, and 52%, respectively. On multivariate analysis, advanced age (hazard ratio [HR]: 1.04; 95% confidence interval [CI]: 1.02-1.05), Charlson-Deyo score of 1 (HR: 1.99; 95% CI: 1.20-3.30), advanced tumor grade (HR: 2.73; 95% CI: 1.39-5.34), and advanced tumor stage (HR: 2.71; 95% CI: 1.33-5.50) were associated with worse OS, whereas surgery (HR: 0.34; 95% CI: 0.20-0.60) and radiation therapy (HR: 0.55; 95% CI: 0.33-0.91), but not chemotherapy (HR: 1.16; 95% CI: 0.66-2.05), predicted improved OS. Conclusions SNAC is a rare malignancy with 5-year survival approximating 50%. Surgery and radiation therapy, but not chemotherapy, are associated with improved survival, and likely play a critical role in the interdisciplinary management of SNAC.
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Affiliation(s)
- Neil N Patel
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Ivy W Maina
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Edward C Kuan
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Vasiliki Triantafillou
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Michal A Trope
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Ryan M Carey
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Alan D Workman
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Charles C Tong
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Michael A Kohanski
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - James N Palmer
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Nithin D Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Jason G Newman
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Jason A Brant
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
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13
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König M, Osnes T, Bratland Å, Jebsen P, Meling TR. Treatment of Sinonasal Adenocarcinoma: A Population-Based Prospective Cohort Study. J Neurol Surg B Skull Base 2019; 81:627-637. [PMID: 33381366 DOI: 10.1055/s-0039-1694050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022] Open
Abstract
Objectives Sinonasal adenocarcinoma (AC) is a potentially curable disease despite being an aggressive malignancy. Long-term survival can be achieved with early diagnosis and adequate multidisciplinary treatment. Our goal was to evaluate outcomes for patients with AC treated at our institution. Design In a population-based consecutive prospective cohort, we conducted an analysis of all patients treated for surface epithelial AC between 1995 and 2018. Results Twenty patients were included, and follow-up was 100%. The mean follow-up time was 89 months for the entire cohort (112 months for patients with no evidence of disease). Intestinal-type AC was found in 65%, whereas nonintestinal-type AC was found in 35% of all cases; 75% had stage T3/4 disease. Tumor grade was intermediate/high in 65%. Eighteen patients underwent treatment with curative intent (craniofacial resection [CFR] in 61%, transfacial approach in 39%, adjuvant radiotherapy in 89%), achieving negative margins in 56% of cases. Overall survival (OS) rates were 90, 68, and 54% after 2, 5, and 10 years of follow-up, respectively, and the corresponding disease-specific survival (DSS) rates were 90, 73, and 58%. Age over 60 years, tumor with a maxillary origin, and microscopic bone invasion were negative prognostic factors. Radical CFR was correlated with better OS and DSS. Conclusion The high probability of achieving radicality with CFR, the low complication rate, the acceptable toxicity of modern irradiation modalities, and the promising survival rates indicate that this strategy might be considered a safe and an effective option for treating patients with very advanced sinonasal AC.
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Affiliation(s)
- Marton König
- Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Terje Osnes
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Otorhinolaryngology, Head and Neck Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Åse Bratland
- Department of Oncology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Peter Jebsen
- Department of Pathology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Torstein R Meling
- Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Service de Neurochirurgie, Département des Neurosciences Cliniques, Hopitaux Universitaires de Genève, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
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14
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Claus J, Jorissen M, Vander Poorten V, Nuyts S, Hermans R, Casteels I, Clement PMJ. Clinically Relevant Response to Cisplatin-5-Fluorouracyl in Intestinal-Type Sinonasal Adenocarcinoma with Loss of Vision: A Case Report. Case Rep Oncol 2019; 12:277-281. [PMID: 31097936 PMCID: PMC6489020 DOI: 10.1159/000499602] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 03/05/2019] [Indexed: 11/19/2022] Open
Abstract
A 68-year-old man presented with rapid progressive visual loss caused by a progressive local invasive sinonasal intestinal-type adenocarcinoma (ITAC) with intracranial invasion. The local relapse of ITAC in the ethmoid sinus was previously treated with palliative radiotherapy and carboplatin-paclitaxel, without response, hence disease progression was seen. Ophthalmological examination revealed irreversible blindness of the left eye and a dramatic progressive visual loss of the right eye. Due to important visual loss caused by optic nerve invasion, a palliative treatment with cisplatin-5-fluorouracyl was started. This therapy resulted in a good clinical response with a regression of the local mass and a partial recovery of the vision.
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Affiliation(s)
- Jonas Claus
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Mark Jorissen
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Vincent Vander Poorten
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Sandra Nuyts
- Department of Radiotherapy-Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Robert Hermans
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Ingele Casteels
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
| | - Paul M J Clement
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
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15
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Bignami M, Lepera D, Volpi L, Lambertoni A, Arosio A, Pistochini A, Nicolai P, Castelnuovo P. Sinonasal Non-Intestinal-Type Adenocarcinoma: A Retrospective Review of 22 Patients. World Neurosurg 2018; 120:e962-e969. [PMID: 30196179 DOI: 10.1016/j.wneu.2018.08.201] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 08/25/2018] [Accepted: 08/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To analyze outcomes and prognostic factors of sinonasal nonsalivary non-intestinal-type adenocarcinoma (n-ITAC.) METHODS: A retrospective review of 22 consecutive patients with n-ITAC was performed. RESULTS Average follow-up time was 77 months. The 5-year overall survival and disease-specific survival were 95.2%. The 5-year overall survival and disease-specific survival were 100% for pT1, pT2, and pT3 tumors and 83.3% for pT4a and pT4b tumors; 100% for G1 tumors and 87.5% for G3 tumors; and 100% for tumors with negative surgical margin and 50% for tumors with positive surgical margin. Stage, grade, and surgical margins were independent prognostic factors. Adjuvant radiotherapy was performed for high-grade and high-stage tumors. CONCLUSIONS Surgery followed by radiotherapy has remained a mainstay for management of n-ITAC, and the endoscopic transnasal approach, when correctly planned and indicated, is the surgery of choice. Adjuvant radiotherapy is recommended in cases of high-stage (T3 and T4) and high-grade tumors. n-ITAC is associated with a favorable outcome. High grade, pT4 stage, and positive surgical margins are independent negative prognostic factors.
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Affiliation(s)
- Maurizio Bignami
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Davide Lepera
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy.
| | - Luca Volpi
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Alessia Lambertoni
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Alberto Arosio
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Andrea Pistochini
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Piero Nicolai
- Department of Otorhinolaryngology, Spedali Civili, University of Brescia, Brescia, Italy
| | - Paolo Castelnuovo
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
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16
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Russel A, Nguyen DT, Vigouroux C, Gallet P, Vignaud JM, Rumeau C, Jankowski R. Compartmentalized endoscopic resection of the olfactory cleft for nasal intestinal adenocarcinomas. Head Neck 2018; 40:2389-2398. [PMID: 29947068 DOI: 10.1002/hed.25349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 01/30/2018] [Accepted: 05/08/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The purpose of this study was to describe the pathology of the different compartments in endoscopic resection of nasal intestinal-type adenocarcinomas (ITACs) and its relationships with oncologic outcomes. METHODS This retrospective study included all patients endoscopically operated for nasal ITACs, followed by radiotherapy in the majority of cases, between 2004 and 2014. The surgery systematically separated 3 compartments: ethmoid lateral mass, olfactory cleft, and anterior cranial fossa (in cases with skull-base invasion) to analyze their pathological "focal" or "massive" invasion by the tumor. RESULTS Sixty-seven patients (aged 69.2 ± 9.8 years) were included. Twenty-nine patients (43.3%) had only pathological focal invasion. At 61.0 ± 41.7 months of mean follow-up, the recurrence rates were 34.2% in the group with massive invasion and 10.3% in the group with focal invasion (P = .023). The disease-specific death rate had a tendency to be higher in the group with massive invasion (23.7% vs 6.9% for the group with focal invasion; P = .097). By Kaplan-Meier analysis, the 5-year disease-specific survival rate was better in the group with focal invasion than the group with massive invasion (P = .01). The 5-year overall survival was not different between the 2 groups (47.4% and 65.5% for focal invasion and massive invasion respectively; P = .14). CONCLUSION Compartmentalized endoscopic resection, combined with postoperative radiotherapy, is one way to operate on nasal ITACs with good oncologic outcomes.
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Affiliation(s)
- Adrien Russel
- Department of ORL - Head and Neck Surgery, Regional University Hospital of Nancy, Hospital of Brabois, Nancy, France.,Faculty of Medicine, University of Lorraine, Vandœuvre-lès-Nancy, France
| | - Duc Trung Nguyen
- Department of ORL - Head and Neck Surgery, Regional University Hospital of Nancy, Hospital of Brabois, Nancy, France.,Faculty of Medicine, University of Lorraine, Vandœuvre-lès-Nancy, France
| | - Charlène Vigouroux
- Department of Pathology, Regional University Hospital of Nancy, Central hospital, Nancy, France
| | - Patrice Gallet
- Department of ORL - Head and Neck Surgery, Regional University Hospital of Nancy, Hospital of Brabois, Nancy, France.,Faculty of Medicine, University of Lorraine, Vandœuvre-lès-Nancy, France
| | - Jean-Michel Vignaud
- Faculty of Medicine, University of Lorraine, Vandœuvre-lès-Nancy, France.,Department of Pathology, Regional University Hospital of Nancy, Central hospital, Nancy, France
| | - Cécile Rumeau
- Department of ORL - Head and Neck Surgery, Regional University Hospital of Nancy, Hospital of Brabois, Nancy, France.,Faculty of Medicine, University of Lorraine, Vandœuvre-lès-Nancy, France
| | - Roger Jankowski
- Department of ORL - Head and Neck Surgery, Regional University Hospital of Nancy, Hospital of Brabois, Nancy, France.,Faculty of Medicine, University of Lorraine, Vandœuvre-lès-Nancy, France
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17
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Martin J, Vayr F, Paris C, Vergez S, Krief P, Luc A, Corvisier J, de Gabory L, Herin F. Nasal fibroscopy as a routine screening procedure of sinonasal adenocarcinoma of woodworkers: French longitudinal case study. Head Neck 2018; 40:2193-2198. [PMID: 29756404 DOI: 10.1002/hed.25315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 10/30/2017] [Accepted: 04/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess the relevancy of flexible nasoendoscopy as a routine screening procedure of sinonasal adenocarcinoma among people occupationally exposed to wood dust. METHODS This study included woodworkers, occupationally exposed to wood dust. Evaluations were scheduled at the time of inclusion (T0) and after a 2-year period (T1). A questionnaire was used for standardized data collection. The score was based on anatomic landmarks on each side that are parts of the olfactory clefts: the area of middle turbinate, the anterior part of the olfactory cleft, the top of the choanal arch, the spheno-ethmoidal recess, the posterior part of the olfactory cleft, and the middle part of the olfactory cleft. RESULTS A total of 965 nasoendoscopies (T0+T1) were performed. Olfactory clefts were visualized in 72% of the cases. Nasoendoscopies revealed pathological findings in 33.6% of cases: polyps, thick nasal secretion aspect, mucous edema, retractile scars and synechia, crusts, mucous erythema, and growth. One case of carcinoma was confirmed. Adverse effects (epistaxis, blood mark on the endo-sheath, sneezing, or rhinorrhea) after the medical procedure occurred in 30% of cases without severe complications. CONCLUSION Flexible nasoendoscopy offers meaningful efficacy and a promising safety profile, and, therefore, could become the new cornerstone of the routine screening procedure of sinonasal adenocarcinoma among woodworkers.
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Affiliation(s)
- Julie Martin
- Occupational Disease Department, CHU de Toulouse, Toulouse, France.,Epidemiology, Health Economics and Public Health, UMR1027 INSERM, Toulouse, France
| | - Flora Vayr
- Occupational Disease Department, CHU de Toulouse, Toulouse, France
| | | | - Sébastien Vergez
- Otolaryngology Department, Head and Neck Surgery, CHU Toulouse, IUCT Oncopole, France.,University of Toulouse 3, CHU de Toulouse, Toulouse, France
| | - Peggy Krief
- Service of Occupational Medicine, Institute for Work and Health, University of Lausanne and Geneva, Epalinges-Lausanne, Switzerland
| | - Amandine Luc
- Research and Innovation Department, CHU de Nancy, Nancy, France
| | - Julie Corvisier
- Research and Innovation Department, CHU de Nancy, Nancy, France
| | | | - Ludovic de Gabory
- Otorhinolaryngology Department, University Hospital of Bordeaux, France
| | - Fabrice Herin
- Occupational Disease Department, CHU de Toulouse, Toulouse, France.,Epidemiology, Health Economics and Public Health, UMR1027 INSERM, Toulouse, France.,University of Toulouse 3, CHU de Toulouse, Toulouse, France
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18
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Gillard AC, Laccourreye L, Desvaux P, Petit A. Évaluation du dépistage systématique des cancers nasosinusiens par suivi ORL et nasofibroscopie chez les travailleurs du bois exposés aux poussières de bois depuis plus de 20 ans. ARCH MAL PROF ENVIRO 2018. [DOI: 10.1016/j.admp.2017.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Oker N, Verillaud B, Wassef M, Froelich S, Bresson D, Kania R, Herman P. Ethmoidal adenocarcinoma treated by exclusive endoscopic approach: Focus on learning curve and modification of management. Head Neck 2017; 40:126-136. [PMID: 29130555 DOI: 10.1002/hed.24990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 07/03/2017] [Accepted: 09/15/2017] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the outcome and recurrences for ethmoidal adenocarcinomas treated by exclusive endoscopic surgery in curative intent and investigate the role of the learning curve. METHODS We conducted a single-center retrospective study, including 60 patients separated in 2 groups (2002-2011 n = 28 and 2012-2015 n = 32). RESULTS The global survival rate at 5 years was 72.6%, and the global and local recurrence rates were 21.6% and 13.3%, respectively. The learning curve had significant impact on global survival at 2 years (93.8% vs 77.8%) and on overall and local recurrences, despite the higher rate of T4 classifications in the latter group. This learning curve could be explained by the evolution toward large endoscopic resection, bilateral, with resection of the cribriform plate, and eventually medial maxillectomy, and started on the healthy side. CONCLUSION For selected cases, exclusive endoscopic resection of ethmoid adenocarcinoma achieves results at least as good as craniofacial resection when performed by an experienced cranial base team and including a large endoscopic resection.
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Affiliation(s)
- Natalie Oker
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Lariboisière, Paris, Cedex, France.,Université Paris Diderot, U.F.R. de Médecine Paris Diderot, Paris, France
| | - Benjamin Verillaud
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Lariboisière, Paris, Cedex, France.,Université Paris Diderot, U.F.R. de Médecine Paris Diderot, Paris, France
| | - Michel Wassef
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Lariboisière, Paris, Cedex, France.,Université Paris Diderot, U.F.R. de Médecine Paris Diderot, Paris, France
| | - Sébastien Froelich
- Service de Neurochirurgie, Hôpital Lariboisière, Paris, Cedex, France.,Université Paris Diderot, U.F.R. de Médecine Paris Diderot, Paris, France
| | - Damien Bresson
- Service de Neurochirurgie, Hôpital Lariboisière, Paris, Cedex, France.,Université Paris Diderot, U.F.R. de Médecine Paris Diderot, Paris, France
| | - Romain Kania
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Lariboisière, Paris, Cedex, France.,Université Paris Diderot, U.F.R. de Médecine Paris Diderot, Paris, France
| | - Philippe Herman
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Lariboisière, Paris, Cedex, France.,Université Paris Diderot, U.F.R. de Médecine Paris Diderot, Paris, France
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20
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A Multicenter Study of Carbon-Ion Radiation Therapy for Head and Neck Adenocarcinoma. Int J Radiat Oncol Biol Phys 2017; 99:442-449. [DOI: 10.1016/j.ijrobp.2017.04.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 01/30/2017] [Accepted: 04/21/2017] [Indexed: 11/17/2022]
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21
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López F, Lund VJ, Suárez C, Snyderman CH, Saba NF, Robbins KT, Vander Poorten V, Strojan P, Mendenhall WM, Rinaldo A, Ferlito A. The Impact of Histologic Phenotype in the Treatment of Sinonasal Cancer. Adv Ther 2017; 34:2181-2198. [PMID: 28871554 DOI: 10.1007/s12325-017-0605-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Indexed: 01/04/2023]
Abstract
The management of sinonasal cancer is a challenge due to its low occurrence and anatomical and significant diversity of histological types. The therapeutic modality used should be tailored individually according to the histology, tumour stage, molecular profile and previous treatments. The clinical management of sinonasal cancer has improved greatly owing to developments in endoscopic surgery and precision radiotherapy. Complete surgical resection is the mainstay of sinonasal malignancies' management but multimodality therapy is associated with improved outcomes in certain histologies. The recognition of various histological types with biological behaviours more suitable for non-surgical modalities has allowed treatment protocols to become more tailored to the disease. In this review we aim to describe and to summarise the current data guiding the management of sinonasal cancer with emphasis on phenotypic variation.
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Affiliation(s)
- Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Oviedo, Spain.
| | - Valerie J Lund
- Professorial Unit, Ear Institute, University College London, London, UK
| | - Carlos Suárez
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Oviedo, Spain
| | - Carl H Snyderman
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - K Thomas Robbins
- Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, ILL, USA
| | - Vincent Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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Michel J, Radulesco T, Penicaud M, Mancini J, Dessi P. Sinonasal adenocarcinoma: clinical outcomes and predictive factors. Int J Oral Maxillofac Surg 2017; 46:422-427. [DOI: 10.1016/j.ijom.2016.11.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 11/30/2016] [Accepted: 11/30/2016] [Indexed: 11/28/2022]
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Mortuaire G, Camous D, Vandenhende-Szymanski C, Dubrulle F, Chevalier D. Local extension staging of sinonasal tumours: retrospective comparison between CT/MRI assessment and pathological findings. Clin Otolaryngol 2017; 42:988-993. [DOI: 10.1111/coa.12827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2017] [Indexed: 12/13/2022]
Affiliation(s)
- G. Mortuaire
- Otorhinolaryngology - Head and Neck Surgery Department; University Hospital; Lille France
- Lille Inflammation Research International Center -Inserm U995; Université de Lille; Lille France
| | - D. Camous
- Otorhinolaryngology - Head and Neck Surgery Department; University Hospital; Lille France
| | - C. Vandenhende-Szymanski
- Otorhinolaryngology - Head and Neck Surgery Department; University Hospital; Lille France
- Lille Inflammation Research International Center -Inserm U995; Université de Lille; Lille France
| | - F. Dubrulle
- Department of Imaging; University Hospital; Lille France
| | - D. Chevalier
- Otorhinolaryngology - Head and Neck Surgery Department; University Hospital; Lille France
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Fiaux-Camous D, Chevret S, Oker N, Turri-Zanoni M, Lombardi D, Choussy O, Duprez F, Jorissen M, de Gabory L, Malard O, Herman P, Nicolai P, Castelnuovo P, Verillaud B. Prognostic value of the seventh AJCC/UICC TNM classification of intestinal-type ethmoid adenocarcinoma: Systematic review and risk prediction model. Head Neck 2017; 39:668-678. [PMID: 28067974 DOI: 10.1002/hed.24663] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The purpose of this study was to propose a prognostic classification of intestinal-type adenocarcinoma (ITAC) based on literature search and prognostic modeling of cohort data. METHODS We first conducted a literature search to assess the homogeneity of the reported estimates of 5-year survival and to identify the influence of T classification. We then pooled prospective data from 3 large French and Italian series to predict time to all-cause mortality. The sample was randomly split to derive and then to validate the proposed prognostic model. RESULTS Literature analysis confirmed the heterogeneity in 5-year survival rates, partly explained in subsets of homogeneous T-values. The sample included 223 patients, randomly separated into a derivation (n = 141) and a validation set (n = 82). Invasion of the sphenoid lateral and/or posterior walls and dura/cerebral invasion were systematically associated with a poor survival. CONCLUSION The incorporation of the invasion of the sphenoid lateral or posterior walls should be considered for ITAC management and prognostication. © 2017 Wiley Periodicals, Inc. Head Neck 39: 668-678, 2017.
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Affiliation(s)
| | - Sylvie Chevret
- Biostatistics and Clinical Epidemiology (ECSTRA) Team, UMR 1153 Inserm, Paris Diderot University, Saint-Louis Hospital, AP-HP, Paris, France
| | - Natalie Oker
- Ear, Nose, and Throat Department, Lariboisière University Hospital, Paris, France
| | | | - Davide Lombardi
- Department of Otorhinolaryngology, University of Brescia, Brescia, Italy
| | - Olivier Choussy
- Ear, Nose, and Throat Department, Rouen University Hospital, Rouen, France
| | - Frederic Duprez
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Marc Jorissen
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Ludovic de Gabory
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Bordeaux, F-X Michelet Center, Bordeaux Cedex, France
| | - Olivier Malard
- Ear, Nose, and Throat Department, CHU Hôtel-Dieu, Nantes, France
| | - Philippe Herman
- Ear, Nose, and Throat Department, Lariboisière University Hospital, Paris, France
| | - Piero Nicolai
- Department of Otorhinolaryngology, University of Brescia, Brescia, Italy
| | - Paolo Castelnuovo
- Department of Otorhinolaryngology, Insubria University, Varese, Italy
| | - Benjamin Verillaud
- Ear, Nose, and Throat Department, Lariboisière University Hospital, Paris, France
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Therapy of sinonasal malignancies invading the orbit-orbital exenteration versus preservation of the orbit plus radiotherapy. J Craniomaxillofac Surg 2016; 45:258-261. [PMID: 28011179 DOI: 10.1016/j.jcms.2016.11.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/28/2016] [Accepted: 11/22/2016] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Orbital invasion is a strong independent prognostic factor for sinonasal malignancies. While there is consent about preservation of the orbit for tumors limited to the orbital periosteum there is controversy about the optimal management of sinonasal malignancies transgressing this barrier. Therefore the aim of our study was to compare exenteration versus preservation of the orbit. MATERIAL AND METHODS 52 patients with sinonasal malignancies invading the orbit beyond the orbital periosteum with involvement of the orbital soft tissues were included in the retrospective study. Prognostic factors were identified through univariate analysis. RESULTS Univariate analysis revealed a significant impact of N-classification (p = 0.017), and treatment strategy (p = 0.016). Exenteration of the orbit was associated with a significantly better 5-year overall survival rate (65.5%) than preservation of the orbit (14%). CONCLUSIONS For patients with invasion of the structures beyond the orbital periosteum, exenteration yields better survival results than preservation of the orbital structures in combination with radiotherapy. In cases where both eyes are affected from the tumor or if only one dysfunctional eye would be left over after therapy, we do not recommend orbital exenteration because life quality would be critically deteriorated.
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Abstract
Sinonasal malignancies are rare and histologically heterogeneous. Treatment is complicated by tumor aggressiveness and location near critical anatomic structures (orbita, skull base, etc.). This low incidence and histologic diversity make prospective studies unfeasible, and thus therapeutic guidelines difficult to establish. The gold standard for surgery is a transfacial approach, with craniofacial resection in case of skull-base involvement. However, these techniques are associated with non-negligible perioperative morbidity. In the past two decades, endoscopic surgery has made major progress, extending its indications: initially developed for functional sinus surgery, it is now applied in benign skull-base pathologies (CSF leakage, meningocele, etc.) and, more recently, in sinonasal malignancy. Literature analysis shows a significant decrease in morbidity and improved quality of life associated with endoscopic endonasal surgery, with oncologic safety and efficacy in well-selected cases, although dependent on operator experience. Additional studies with longer follow-up and comparison between histologic subtypes will be needed.
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27
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Mortuaire G, Leroy X, Vandenhende-Szymanski C, Chevalier D, Thisse AS. Comparison of endoscopic and external resections for sinonasal instestinal-type adenocarcinoma. Eur Arch Otorhinolaryngol 2016; 273:4343-4350. [PMID: 27363404 DOI: 10.1007/s00405-016-4181-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 06/25/2016] [Indexed: 10/21/2022]
Abstract
Endoscopic sinus surgery (ESS) is considered as a valid option in the management of nasal adenocarcinoma (ADC). Comparative studies with open approaches are still required. A monocentric retrospective study was carried out from May 2002 to December 2013, including 43 patients with intestinal-type adenocarcinoma of the ethmoid sinus. Non-resectable tumours or recurrences were excluded. Before 2008, open approach with lateral rhinotomy (LR) was performed as the gold standard of treatment. From 2008, ESS was systematically used as a first-line option as long as a complete resection was achievable. Adjuvant radiation therapy was delivered (RT) for all the patients. LR and ESS were performed in, respectively, 23 and 20 patients. The two groups were comparable in terms of age, occupational dust exposure, histopathological subtypes, and T stage based on the pathological assessment of the specimen (10 pT2, 26 pT3, 2 pT4a, and 5 pT4b). The tumour origin was mainly located in the olfactory cleft with the involvement of the cribriform plate in 60 % of patients. No major complication was observed in ESS group with a reduced hospital stay (5.6 vs 7.6 days). The disease-free survival was not different between LR and ESS groups over a mean follow-up period of 6.6 years. Even for local advanced stages with skull base involvement, we confirm the reliability and the advantages of ESS in terms of oncological outcomes and morbidity. We advocate complete excision of the olfactory cleft to ensure an appropriate control of the tumoral origin.
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Affiliation(s)
- Geoffrey Mortuaire
- Otorhinolaryngology-Head and Neck Surgery Department, University Hospital, Lille, France. .,Université de Lille 2, Lille, France. .,Service d'ORL de chirurgie cervico-faciale, Hôpital Huriez CHRU Lille, Lille, 59000, France.
| | - Xavier Leroy
- Université de Lille 2, Lille, France.,Pathology Department, University Hospital, Lille, France
| | | | - Dominique Chevalier
- Otorhinolaryngology-Head and Neck Surgery Department, University Hospital, Lille, France.,Université de Lille 2, Lille, France
| | - Anne-Sophie Thisse
- Otorhinolaryngology-Head and Neck Surgery Department, University Hospital, Lille, France
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Hoeben A, van de Winkel L, Hoebers F, Kross K, Driessen C, Slootweg P, Tjan-Heijnen VCG, van Herpen C. Intestinal-type sinonasal adenocarcinomas: The road to molecular diagnosis and personalized treatment. Head Neck 2016; 38:1564-70. [PMID: 27224655 DOI: 10.1002/hed.24416] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 11/03/2015] [Accepted: 12/29/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Sinonasal intestinal-type adenocarcinomas (ITACs) are epithelial tumors of the nasal cavity and the paranasal sinuses, often related to professional exposure to organic dust, mainly wood or leather. It is a rare cancer. If resectable, surgery is the treatment of choice. Postoperative radiotherapy is often indicated to increase local control. Systemic treatment (chemotherapy, targeted agents, or immunotherapy) of irresectable ITACs and/or metastasized disease is less standardized. METHODS Articles on ITAC histopathology, molecular profile, and current treatment options of this specific tumor were identified and reviewed, using the electronic databases Pubmed, Medline, Cochrane, and Web of Science. RESULTS This article reviews what is currently known on the histopathology, tumorigenesis, molecular characteristics, and standardized treatment options of ITAC. CONCLUSION More translational research is needed to identify druggable targets that may lead to a personalized treatment plan in order to improve long-term outcome in patients with locally advanced and/or metastasized ITAC. © 2016 Wiley Periodicals, Inc. Head Neck 38: First-1570, 2016.
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Affiliation(s)
- Ann Hoeben
- Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Linda van de Winkel
- Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Frank Hoebers
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kenneth Kross
- Department of Otolaryngology/Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Chantal Driessen
- Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Pieter Slootweg
- Department of Pathology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Vivianne C G Tjan-Heijnen
- Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Carla van Herpen
- Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Turri-Zanoni M, Battaglia P, Lambertoni A, Giovannardi M, Schreiber A, Volpi L, Bolzoni-Villaret A, Lombardi D, Bignami M, Magnoli F, Facco C, Antognoni P, Nicolai P, Castelnuovo P. Treatment strategies for primary early-stage sinonasal adenocarcinoma: A retrospective bi-institutional case-control study. J Surg Oncol 2015; 112:561-7. [PMID: 26346184 DOI: 10.1002/jso.24038] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/26/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate different treatment strategies for primary early-stage (pT1-T2) sinonasal adenocarcinomas. METHODS Retrospective case-control study. From 2000 to 2011, 61 cases were radically resected using an endoscopic endonasal approach. Surgery as a single treatment modality was adopted for 33 patients (study group) while it was followed by postoperative radiotherapy (poRT) in 28 patients (control group). RESULTS Median follow-up was 61 and 67 months for the study and control group respectively. Patients were stratified according to the pT classification and no statistically significant differences were found in terms of Overall (OS) and Recurrence-free (RFS) survival. When analyzing the high-grade tumors (47 cases), statistically significant differences were observed between the control and study groups both in terms of OS (90.5% ± 6.5% versus 57.6% ± 15.4%, P = 0.03) and RFS (92.3% ± 7.39% versus 80.2% ± 8.88%, P = 0.05). Using multivariate analysis, OS was independently determined by poRT (Hazard Ratio = 0.16; P = 0.03) thus confirming its protective role for high-grade adenocarcinomas. CONCLUSION Our preliminary results suggest that endoscopic endonasal surgery could be used as a single treatment modality for primary early-stage low-grade sinonasal adenocarcinoma, resected with negative margins. Surgery followed by poRT offers the best treatment strategy not only for advanced-stage lesions but also for high-grade adenocarcinomas, regardless of the stage of disease at presentation.
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Affiliation(s)
- Mario Turri-Zanoni
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Azienda Ospedaliero-Universitaria Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Head and Neck Surgery & Forensic Dissection Research center (HNS&FDRc), DBSV, University of Insubria, Varese, Italy
| | - Paolo Battaglia
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Azienda Ospedaliero-Universitaria Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Head and Neck Surgery & Forensic Dissection Research center (HNS&FDRc), DBSV, University of Insubria, Varese, Italy
| | - Alessia Lambertoni
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Azienda Ospedaliero-Universitaria Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Marta Giovannardi
- Unit of Biostatistics, Department of Statistics, Monzino Hospital, Milan, Italy
| | - Alberto Schreiber
- Unit of Otorhinolaryngology, Spedali Civili di Brescia, University of Brescia, Italy
| | - Luca Volpi
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Azienda Ospedaliero-Universitaria Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | | | - Davide Lombardi
- Unit of Otorhinolaryngology, Spedali Civili di Brescia, University of Brescia, Italy
| | - Maurizio Bignami
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Azienda Ospedaliero-Universitaria Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | | | - Carla Facco
- Division of Pathology, University of Insubria, Varese, Italy
| | - Paolo Antognoni
- Division of Radiation Oncology, University of Insubria, Varese, Italy
| | - Piero Nicolai
- Unit of Otorhinolaryngology, Spedali Civili di Brescia, University of Brescia, Italy
| | - Paolo Castelnuovo
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Azienda Ospedaliero-Universitaria Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Head and Neck Surgery & Forensic Dissection Research center (HNS&FDRc), DBSV, University of Insubria, Varese, Italy
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Nicolai P, Schreiber A, Bolzoni Villaret A, Lombardi D, Morassi L, Raffetti E, Donato F, Battaglia P, Turri-Zanoni M, Bignami M, Castelnuovo P. Intestinal type adenocarcinoma of the ethmoid: Outcomes of a treatment regimen based on endoscopic surgery with or without radiotherapy. Head Neck 2015; 38 Suppl 1:E996-E1003. [PMID: 26040823 DOI: 10.1002/hed.24144] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/08/2015] [Accepted: 05/31/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess survival, prognostic factors, and complications in a cohort of patients with intestinal-type adenocarcinoma (ITAC) treated with transnasal endoscopic surgery ± radiotherapy (RT). METHODS Patients with ITAC who underwent endoscopic surgery ± RT at 2 tertiary centers were retrospectively reviewed. Overall survival (OS) and event-free survival were calculated, and statistically significant variables were entered in a multivariate Cox regression model. Complications were also analyzed. RESULTS One hundred-sixty-nine patients were included. Major complications occurred in 9.5% of patients. Adjuvant RT was delivered in 58.6% of patients. Five-year OS and event-free survival were 68.9% and 63.6%, respectively. Advanced pT classification, high-grade, and positive surgical margins were independently predictive of poor survival. CONCLUSION Endoscopic surgery ± RT is a valid treatment option in most cases of ITAC. When compared with series based on external surgery, our results support a definitive paradigm shift in the management of ITAC. © 2015 Wiley Periodicals, Inc. Head Neck 38: E996-E1003, 2016.
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Affiliation(s)
- Piero Nicolai
- Unit of Otorhinolaryngology, University of Brescia, Brescia, Italy
| | | | | | - Davide Lombardi
- Unit of Otorhinolaryngology, University of Brescia, Brescia, Italy
| | - Laura Morassi
- Unit of Pathology, University of Brescia, Brescia, Italy
| | - Elena Raffetti
- Unit of Epidemiology and Public Health, University of Brescia, Brescia, Italy
| | - Francesco Donato
- Unit of Epidemiology and Public Health, University of Brescia, Brescia, Italy
| | - Paolo Battaglia
- Unit of Otorhinolaryngology, Insubria University, Varese, Italy
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Meccariello G, Deganello A, Choussy O, Gallo O, Vitali D, De Raucourt D, Georgalas C. Endoscopic nasal versus open approach for the management of sinonasal adenocarcinoma: A pooled-analysis of 1826 patients. Head Neck 2015; 38 Suppl 1:E2267-74. [DOI: 10.1002/hed.24182] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2015] [Indexed: 11/05/2022] Open
Affiliation(s)
- Giuseppe Meccariello
- Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | - Alberto Deganello
- Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | | | - Oreste Gallo
- Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | - Daniele Vitali
- Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | | | - Christos Georgalas
- Endoscopic Skull Base Center, Department of Otorhinolaryngology, Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
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McMahon JD, Crowther J, Taylor WM, Wong LS, Paterson T, Devine J, Wales C, MacIver C. Anterolateral corridor approach to the infratemporal fossa and central skull base in maxillectomy: rationale and technical aspects. Br J Oral Maxillofac Surg 2015. [PMID: 26212419 DOI: 10.1016/j.bjoms.2015.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We describe the technical aspects and report our clinical experience of a surgical approach to the infratemporal fossa that aims to reduce local recurrence after operations for cancer of the posterior maxilla. We tested the technique by operating on 3 cadavers and then used the approach in 16 patients who had posterolateral maxillectomy for disease that arose on the maxillary alveolus or junction of the hard and soft palate (maxillary group), and in 19 who had resection of the masticatory compartment and central skull base for advanced sinonasal cancer (sinonasal group). Early proximal ligation of the maxillary artery was achieved in all but one of the 35 patients. Access to the infratemporal fossa enabled division of the pterygoid muscles and pterygoid processes under direct vision in all cases. No patient in the maxillary group had local recurrence at median follow up of 36 months. Four patients (21%) in the sinonasal group had local recurrence at median follow up of 27 months. Secondary haemorrhage from the cavernous segment of the internal carotid artery resulted in the only perioperative death. The anterolateral corridor approach enables controlled resection of tumours that extend into the masticatory compartment.
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Affiliation(s)
- Jeremy D McMahon
- Consultant Maxillofacial Head Neck Surgeon, Southern General Hospital, Glasgow G514TF, UK.
| | - John Crowther
- Consultant ENT Skull Base Surgeon, Southern General Hospital, Glasgow G514TF, UK
| | - William M Taylor
- Consultant Neurosurgeon, Southern General Hospital, Glasgow G514TF, UK
| | - Ling Siew Wong
- Oral and Maxillofacial Surgeon, Hospital Sibu, Sarawak, Malaysia
| | | | - John Devine
- Consultant Maxillofacial head Neck Surgeon, Southern General Hospital, Glasgow G514TF, UK
| | - Craig Wales
- Consultant Maxillofacial head Neck Surgeon, Southern General Hospital, Glasgow G514TF, UK
| | - Colin MacIver
- Consultant Maxillofacial head Neck Surgeon, Southern General Hospital, Glasgow G514TF, UK
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Koto M, Hasegawa A, Takagi R, Sasahara G, Ikawa H, Mizoe JE, Jingu K, Tsujii H, Kamada T, Okamoto Y. Feasibility of carbon ion radiotherapy for locally advanced sinonasal adenocarcinoma. Radiother Oncol 2014; 113:60-5. [DOI: 10.1016/j.radonc.2014.09.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 09/09/2014] [Accepted: 09/20/2014] [Indexed: 11/28/2022]
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Bhayani MK, Yilmaz T, Sweeney A, Calzada G, Roberts DB, Levine NB, DeMonte F, Hanna EY, Kupferman ME. Sinonasal adenocarcinoma: a 16-year experience at a single institution. Head Neck 2014; 36:1490-6. [PMID: 23996784 DOI: 10.1002/hed.23485] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 06/24/2013] [Accepted: 08/23/2013] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Adenocarcinoma is a rare tumor of the sinonasal tract. The purpose of this study was to characterize a single institution's experience with this malignancy. METHODS Retrospective review was performed of patients with adenocarcinoma of the sinonasal tract from 1993 to 2009. Demographic data, disease presentation, treatment, and survival rates were collected and evaluated. RESULTS We identified 66 patients with sinonasal adenocarcinoma; 48 were men and 18 women. Average age at time of diagnosis was 57.1 years (range, 20-88 years), and median follow-up was 55.3 months (range, 1-238 months). The ethmoid sinus (38%) and nasal cavity (36%) were the most common sites of origin. Nasal obstruction (36%), epistaxis (30%), and nasal discharge (21%) were the most common presenting symptoms. Fifty-one percent of patients presented with T1 or T2 tumors. Surgery was the primary form of treatment in 81% of patients. Twenty-six percent of surgical patients underwent an endoscopic tumor resection. Adjuvant radiation was utilized in 50% of patients and chemotherapy in 10%. Recurrence was seen in 24 patients (37%): 29% recurred locally and 7.6% recurred distantly. The overall 5-year survival was 65.9%. Survival was decreased significantly in patients with T4 tumors (p < .05), high-grade histology (p < .05), and sphenoid sinus involvement (p < .05). Survival was not affected by surgical approach between endoscopic and open approaches (p = .76). CONCLUSION Sinonasal adenocarcinomas are commonly identified in the sinonasal cavity and are associated with a relatively favorable prognosis, despite a substantial local failure rate of 30%. Advanced-stage tumors, sphenoid sinus and skull base invasion, and high-grade histology portend poor prognosis. In our experience, endoscopic resection was not associated with adverse outcomes and suggests that this minimally invasive approach can provide acceptable oncologic outcomes in selected patients.
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Affiliation(s)
- Mihir K Bhayani
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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35
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Veloso-Teles R, Ribeiro I, Castro-Silva J, Monteiro E. Adenocarcinomas of the sinonasal tract: a case series from an Oncology Centre in Northern Portugal. Eur Arch Otorhinolaryngol 2014; 272:1913-21. [PMID: 25193547 DOI: 10.1007/s00405-014-3265-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 08/28/2014] [Indexed: 02/03/2023]
Abstract
Sinonasal malignant neoplasms are rare and adenocarcinomas account for 10-20 % of these cancers. Our aim is to characterise the clinical presentation, risk factors and outcomes of patients with adenocarcinoma treated at our institution. Retrospective review of medical records of patients with sinonasal adenocarcinomas, treated at IPO-Porto from January 2008 until December 2012. Twenty-eight patients with adenocarcinomas were selected from a total of 53 patients with sinonasal cancers. There was a male predominance (93 %), a mean age at diagnosis of 56 years and a rate of occupational wood dust exposure of 71 %. The most common treatment option was surgery followed by adjuvant radiotherapy. The 5 year disease-free and cancer-specific survival was 58 and 60 %, respectively. The following factors had negative impact on disease-free survival: advanced AJCC stage (p = 0.014); skull base invasion (p = 0.002); poorly differentiated or mucinous subtypes histology (p = 0.034) and imaging findings of residual tumour before adjuvant radiotherapy (p < 0.001). Endoscopic tumour resection was not associated with adverse outcomes. The role of volume-modulated arch therapy in the treatment of sinonasal tumours has to be clarified. The higher rate of adenocarcinomas among sinonasal cancers in this series comparing with previous reports, even from our institution, suggests that this pathology is rising in Northern Portugal. Despite substantial local failure, sinonasal adenocarcinomas have a relatively favourable prognosis in terms of cancer-specific survival.
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Affiliation(s)
- R Veloso-Teles
- Department of Otorhinolaryngology, Alto Ave Hospital Centre (CHAA), Rua dos Cutileiros, Creixomil, 4835-044, Guimarães, Portugal,
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D'Aguillo CM, Kanumuri VV, Khan MN, Sanghvi S, Patel NR, Baredes S, Eloy JA. Demographics and survival trends of sinonasal adenocarcinoma from 1973 to 2009. Int Forum Allergy Rhinol 2014; 4:771-6. [PMID: 24850785 DOI: 10.1002/alr.21342] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/20/2014] [Accepted: 04/08/2014] [Indexed: 07/13/2024]
Abstract
BACKGROUND The purpose of this work was to study the demographics and survival of patients diagnosed with sinonasal adenocarcinoma (SNAC) within the time period of 1973 to 2009 using the Surveillance, Epidemiology, and End Result (SEER) database. METHODS A retrospective cohort study using the U.S. National Cancer Institute's SEER registry was performed to study the demographics and survival for SNAC from 1973 to 2009. Analysis was conducted based on race, gender, and stage. RESULTS In total, 1270 cases of SNAC were analyzed for demographics and survival. Males accounted for 51.6% of cases, while females accounted for 48.4% of cases, amounting to a male to female ratio of 1.06:1.00. Disease specific survival at 5, 10, 15, and 20 years was 65.2%, 50.9%, 40.9%, and 36.5%, respectively. When analyzed by gender, females had higher survival than males, although this difference was not statistically significant. When analyzed by race, the category of other, which encompasses American Indian, Asian, Hispanic, and unknown or unspecified race, was shown to have the best survival, followed by whites and blacks, respectively. CONCLUSION SNAC is a rare tumor classically associated with occupational exposure and carries a variable prognosis. This is the first dedicated large-scale, retrospective analysis of a North American SNAC population. SNAC appears to affect both males and females equally and predominantly affects whites. Patients categorized as other had significantly better survival outcomes, while gender appeared to have no significant effect on survival.
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Affiliation(s)
- Christine M D'Aguillo
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
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Abstract
In patients' management affected by head and neck cancers, surgery takes a major place with radiotherapy and chemotherapy. An updating of the surgical techniques available, and validated indications seems useful to harmonize the head and neck oncological surgery practices and so optimize its safety. A focus on the quality assurance in head and neck surgical oncology is proposed.
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Radionecrosis of the frontal lobe as a consequence of malignant ethmoid tumor management: incidence, diagnosis, risk factors, prevention and management. Eur Arch Otorhinolaryngol 2014; 271:3223-32. [DOI: 10.1007/s00405-014-3013-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 03/16/2014] [Indexed: 10/25/2022]
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Vergez S, du Mayne MD, Coste A, Gallet P, Jankowski R, Dufour X, Righini C, Reyt E, Choussy O, Serrano E, Crampette L, Debry C, de Gabory L. Multicenter study to assess endoscopic resection of 159 sinonasal adenocarcinomas. Ann Surg Oncol 2013; 21:1384-90. [PMID: 24264517 DOI: 10.1245/s10434-013-3385-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE This study was designed to assess the efficacy and morbidity of the endoscopic endonasal approach for the treatment of sinonasal adenocarcinomas. METHODS This was a retrospective, multicenter study of nine French tertiary referral centers, including untreated patients. All patients were operated by an endoscopic approach. Tumors were classified according to the UICC 2002. Demographic, therapeutic, histological, morbidity data, and the course of the disease were recorded. Survival rates were obtained using the Kaplan-Meier method. RESULTS A total of 159 patients were included with a mean age of 69 years. There were 19T1, 62T2 (1M1), 36T3 (1N1), 26T4a, and 16T4b (1N2a-1N2c). The mean duration of hospitalization was 4.4 days. The histologic outcomes showed that the olfactory cleft, the posterior and anterior ethmoid sinus, and the sphenoid, maxillary, and frontal sinuses were invaded in 95, 64, 55, 19, 7, and 3 % of cases, respectively. Histologic margins were positive in 17 % (1T1, 4T2, 3T3, 2T4a, and 8T4b). In total, 130 patients received adjuvant radiotherapy on the primary tumor site (58 Gy), 24 cases were not irradiated, and 5 refused treatment. The mean follow-up was 32.5 ± 24 months. The complication rate was 19 %: 6 epistaxis, 3 meningitis, 6 CSF leaks, 2 dacryocystitis, and 8 septoplasties. The recurrence rate was 17.6 % (28 cases) within 23 ± 21 months. Eleven patients underwent a second surgical procedure. Nine patients died of their disease (3T2, 2T3, 4T4b). The global and disease-specific, recurrence-free survival rate at 3 years was 74 and 84 % respectively. CONCLUSIONS The endoscopic approach seems to be efficient to remove sinonasal adenocarcinoma with low morbidity.
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Affiliation(s)
- Sebastien Vergez
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Rangueil-Larrey, Toulouse, France
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Arana Yi C, McCue P, Rosen M, Machtay M, Axelrod R, Morris GJ. Sarcoidosis Mimicking Metastatic Bone Disease in Head and Neck Cancer. Semin Oncol 2013; 40:529-34. [DOI: 10.1053/j.seminoncol.2013.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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MBAYE MAGUETTE, POPA CLAUDIU, SIGNORELLI FRANCESCO, STREICHENBERGER NATHALIE, COSMIDIS ALAIN, POZZI FABIO, GUYOTAT JACQUES. Vertebroepidural metastasis of an ethmoid adenocarcinoma: A case report. Oncol Lett 2013; 6:1007-1010. [PMID: 24137454 PMCID: PMC3796407 DOI: 10.3892/ol.2013.1511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 04/02/2013] [Indexed: 11/06/2022] Open
Abstract
Ethmoid adenocarcinoma is the most frequent ethmoid tumor. To date, only a single case of spinal cord compression resulting from ethmoid adenocarcinoma has been reported. The current case study presents a recent case of vertebroepidural metastasis of an ethmoid adenocarcinoma leading to spinal cord compression. Modern imaging studies, including magnetic resonance imaging (MRI) and 18 fludeoxyglucose positron emission tomography (FDG PET), as well as histological and immunohistochemical analyses, have led to diagnoses of a metastasis of an ethmoid adenocarcinoma, which is a mucinous variant, dedifferentiated when compared to the primary tumor. The present case discusses current diagnostic and treatment protocols of this condition. Since survival rates associated with the primary tumor are improving, the incidence of spinal metastasis of ethmoid carcinomas is likely to increase in the future, therefore requiring appropriate diagnostic and therapeutic management.
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Affiliation(s)
- MAGUETTE MBAYE
- Lyon Civil Hospitals, Pierre Wertheimer Neurological and Neurosurgical Hospital, Service of Neurosurgery D, Lyon 69500, France
| | - CLAUDIU POPA
- Lyon Civil Hospitals, Pierre Wertheimer Neurological and Neurosurgical Hospital, Service of Neurosurgery D, Lyon 69500, France
| | - FRANCESCO SIGNORELLI
- Lyon Civil Hospitals, Pierre Wertheimer Neurological and Neurosurgical Hospital, Service of Neurosurgery D, Lyon 69500, France,Magna Græcia University, Department of Experimental and Clinical Medicine, Catanzaro 88100, Italy,Correspondence to: Professor Francesco Signorelli, Pierre Wertheimer Neurological and Neurosurgical Hospital, Service of Neurosurgery D, 59 Boulevard Pinel, Lyon F-69500, France, E-mail:
| | - NATHALIE STREICHENBERGER
- Lyon Civil Hospitals, Pierre Wertheimer Neurological and Neurosurgical Hospital, Pathological Anatomy Service, Lyon 69500, France
| | | | - FABIO POZZI
- Lyon Civil Hospitals, Pierre Wertheimer Neurological and Neurosurgical Hospital, Service of Neurosurgery D, Lyon 69500, France
| | - JACQUES GUYOTAT
- Lyon Civil Hospitals, Pierre Wertheimer Neurological and Neurosurgical Hospital, Service of Neurosurgery D, Lyon 69500, France
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Kreppel M, Scheer M, Beutner D, Drebber U, Semrau R, Zöller JE, Guntinas-Lichius O. Stage grouping in tumors of the ethmoid sinuses and the nasal cavity using the sixth edition of the UICC classification of malignant tumors. Head Neck 2012; 35:257-64. [PMID: 22307999 DOI: 10.1002/hed.22951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2011] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the prognostic impact of the sixth edition of the Union Internationale Contre le Cancer (UICC) classification and different TNM-based stage groupings for malignant tumors of the ethmoid sinuses and the nasal cavity. METHODS We conducted a retrospective analysis of 98 patients with malignant tumors of the ethmoid sinuses and the nasal cavity between 1967 and 2003. The UICC classification of the sixth edition and the T and N Integer Score (TANIS) and Hart were tested for their prognostic significance. RESULTS In univariate analysis, all stage groupings revealed discriminatory power for overall survival (OS; p < .05), however, in multivariate analysis only the UICC-stage grouping (p = .033) and the TANIS-8 scheme (p = .044) predicted OS. The TANIS did not have a better prognostic quality than the sixth edition of the UICC classification. CONCLUSION The UICC-stage grouping of the sixth edition is a good prognostic index for malignant tumors of the ethmoid sinuses and the nasal cavity.
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Affiliation(s)
- Matthias Kreppel
- Department of Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, 50931 Cologne, Germany.
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Vergez S, Martin-Dupont N, Lepage B, De Bonnecaze G, Decotte A, Serrano E. Endoscopic vs Transfacial Resection of Sinonasal Adenocarcinomas. Otolaryngol Head Neck Surg 2012; 146:848-53. [DOI: 10.1177/0194599811434903] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives. Compare the survival and the complication rates of 2 comparable groups of patients who underwent either endoscopic or transfacial resection of a sinonasal adenocarcinoma. Study Design. Historical cohort study. Setting. Tertiary referral center. Subjects and Methods. Twenty-four patients with sinonasal adenocarcinomas who recently underwent an endoscopy (the ENDO group, 1999-2009) were compared with 24 patients who underwent a lateral rhinotomy procedure (the LR group, 1993-2007). The present retrospective study included patients who would have had an endoscopic resection in 2011. Results. The groups were comparable in terms of age and sex ( P = .49), as well as tumor stages; 43 of the 48 patients had undergone postoperative radiotherapy. There were 13 T1-T2 and 11 T3-T4 tumors in the ENDO group compared with 12 T1-T2 and 12 T3-T4 tumors in the LR group ( P = .77). The mean length of follow-up was 38 months for the ENDO group and 89 for the LR group. The overall survival and recurrence-free rates were not significantly different ( P = .3 and P = .87, respectively). The median duration of hospitalization was significantly shorter in the ENDO group than in the LR group (4 vs 8 days, P < .0001). The rate of early complications was identical in both groups (12.5%). Conclusion. The endoscopic approach is a safe and effective treatment in selected sinonasal adenocarcinoma cases. The early oncological outcome and morbidity associated with the endoscopic approach were comparable with a transfacial approach. Hospitalization was significantly reduced by the endoscopic approach. Although the endoscopic approach is less invasive, it requires an optimal preoperative imaging protocol and an experienced surgical team.
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Affiliation(s)
| | | | | | | | - Anne Decotte
- University Hospital Rangueil-Larrey, Toulouse, France
| | - Elie Serrano
- University Hospital Rangueil-Larrey, Toulouse, France
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Porez F, de Pommerol MJ, Krief P, Conso F, Stoll D, de Gabory L. Assessment of nasal fibroscopy to explore olfactory cleft. Otolaryngol Head Neck Surg 2011; 145:677-82. [PMID: 21622802 DOI: 10.1177/0194599811410273] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess whether flexible nasoendoscopy can be used to visualize all parts of the olfactory cleft (OC) without morbidity. STUDY DESIGN Single-center, prospective, observational study. SETTING French tertiary referral center. SUBJECTS AND METHODS 100 consecutive patients were divided in 2 groups of 50. Group 1 underwent nasal fibroscopy without vasoconstriction or local anesthesia with an endosheath- protected endoscope. Group 2 was examined by a fiberscope without an endosheath after application of naphazoline Xylocaine. Each OC was divided in 16 items recorded as visualized or not. Four scores were compared between both groups: out of 16 (1 side), out of 32 (both sides), out of 12 concerning only the narrowest and highest bilateral spaces, and out of 4 to divide these specific areas in anterior, middle, and posterior parts. Length of procedure, pain, epistaxis, blood mark on the endosheath, sneezing, rhinorrhea, and causes of failure were recorded. RESULTS There was no significant difference between both groups concerning score out of 16 or 32. The visibility of the narrower and higher spaces was better in group 2: scores out of 12 were significantly different between the groups (P = .025), as were scores out of 4 for the anterior and middle parts of the OC (P = .02 and .01 respectively). Morbidity was low without differences between the groups. Deviated nasal septum was the only cause of failure and increased the patients' pain during the examination (P = .045). CONCLUSION Nasal fibroscopy could be used to explore the different portions of the OC efficiently and with low morbidity.
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Affiliation(s)
- Florence Porez
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Bordeaux, Centre F-X Michelet, place Amélie Raba-Léon, France
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Breheret R, Laccourreye L, Jeufroy C, Bizon A. Adenocarcinoma of the ethmoid sinus: retrospective study of 42 cases. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 128:211-7. [PMID: 21616740 DOI: 10.1016/j.anorl.2011.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Revised: 02/21/2011] [Accepted: 02/23/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Retrospective analysis of the oncological results and morbidity of ethmoid sinus adenocarcinoma surgery, and identification of survival factors. MATERIAL AND METHODS Forty-two patients were treated from 1990 to 2009. The study covered clinical presentation, medical imaging, histologic data, TNM grade, treatment, morbidity and overall recurrence-free survival. RESULTS Forty-one men and one woman, with mean age at diagnosis of 61.5 years, were included. 85.7% had been exposed to wood dust. Twenty patients (47.6%) were graded T4 at diagnosis. Thirty-three (78.5%) were treated by surgery followed by radiation therapy; nearly half of these showed recurrence. Overall specific 5-year survival was 44.2% at 5 years and recurrence-free 5-year survival 46.4%. The factors of poor prognosis found were cerebromeningeal or orbital invasion and local recurrence. CONCLUSION This series confirms the epidemiological literature on ethmoid adenocarcinoma and the influence of poor prognosis factors. Survival depended directly on local tumor control and seemed to be enhanced on an isolated transfacial approach.
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Affiliation(s)
- R Breheret
- Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, centre hospitalier universitaire d'Angers, 20, rue de Savoie, 49100 Angers cedex 01, France.
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Lund VJ, Chisholm EJ, Takes RP, Suárez C, Mendenhall WM, Rinaldo A, Llorente JL, Terhaard CHJ, Rodrigo JP, Maughan E, Ferlito A. Evidence for treatment strategies in sinonasal adenocarcinoma. Head Neck 2011; 34:1168-78. [PMID: 21523846 DOI: 10.1002/hed.21770] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2011] [Indexed: 11/10/2022] Open
Abstract
Adenocarcinomas of various types account for 10% to 20% of all primary malignant neoplasms of the nasal cavity and paranasal sinuses. There is a general consensus that the optimal treatment of adenocarcinoma is surgery and postoperative radiotherapy. The purpose of this report was to review the results of this combined treatment as well as other treatment strategies and their outcome. Most series present outcome data from a heterogeneous group of patients, with a wide variety of tumor subtypes presenting at differing stages, who received a variety of treatment strategies. Surgical excision remains the treatment of choice. The choice of approach is determined by what will best allow complete excision of the disease. Endoscopic techniques, if feasible for complete removal of the tumor, offer results comparable to those of external approaches with lower morbidity. Although clear evidence to support the use of radiotherapy in sinonasal adenocarcinoma is difficult to obtain, local control rates of combined treatment strategies for advanced cases are comparable to less advanced cases with surgery alone, suggesting a positive role for postoperative radiotherapy. However, the importance of thorough surgical resection should be stressed.
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Affiliation(s)
- Valerie J Lund
- Ear Institute, University College London, London, United Kingdom
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Nicolai P, Villaret AB, Bottazzoli M, Rossi E, Valsecchi MG. Ethmoid adenocarcinoma--from craniofacial to endoscopic resections: a single-institution experience over 25 years. Otolaryngol Head Neck Surg 2011; 145:330-7. [PMID: 21515803 DOI: 10.1177/0194599811403873] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To identify factors that influence hospitalization time, complications, and prognosis of patients with ethmoid adenocarcinoma treated with different surgical techniques. DESIGN Single-institution retrospective review. SETTING Academic tertiary care center. PATIENTS Sixty-seven patients with ethmoid adenocarcinoma treated from January 1985 to August 2009 were retrospectively evaluated. Surgical treatment included endoscopic resection (n = 12), endoscopic resection with transnasal craniectomy (n = 17), cranioendoscopic resection (n = 9), external approaches limited to the ethmoid (n = 11), and craniofacial resection (n = 18). MAIN OUTCOME MEASURES A Cox model was adopted to relate time to death to previous treatment, pT category, grade, and surgical technique. The impact of the same variables on hospitalization time and risk of complications was assessed by linear regression and logistic regression, respectively. RESULTS The risk of complications increased for pT4a-b lesions (P = .02) and craniofacial resection (P = .01). Hospitalization time increased by 6.3 days for cranioendoscopic resection (P = .03) and by 11.7 days for craniofacial resection (P < .001). Three- and 5-year overall survivals were 68.0% (standard error = 5.8%) and 48.4% (standard error = 6.9%). Three-year survival was 76.62% and 51.81% for previously untreated and treated patients, respectively, and it was 92.98% and 33.33% in patients treated with endoscopic techniques and craniofacial resection, respectively. Multivariate analysis showed that previous treatment (hazard ratio of death = 3.9, P = .01) and craniofacial resection (HR = 5.16, P = .05) were mainly associated with survival. CONCLUSIONS Endoscopic techniques, in properly selected patients, were associated with a favorable oncologic outcome and a statistically significant reduction in both complication rate and hospitalization time. This study supports the role of endoscopic techniques in surgical treatment of ethmoid adenocarcinoma.
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Affiliation(s)
- Piero Nicolai
- Department of Otorhinolaryngology, University of Brescia, Brescia, Italy
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Recommandations pour la surveillance médicoprofessionnelle des travailleurs exposés à l’effet cancérigène des poussières de bois. ARCH MAL PROF ENVIRO 2011. [DOI: 10.1016/j.admp.2011.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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