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Khalaf M, De Kermadec H, Hershkovitch J, Casiraghi O, Garcia G, Bidault F, Ferrand FR, Nguyen F, Temam S, Blanchard P, Bresson D, Moya Plana A. Safety and Oncologic Outcomes of Endoscopic Endonasal Transcribriform Approach for Locally Advanced Sinonasal Malignancies. Head Neck 2025. [PMID: 40420621 DOI: 10.1002/hed.28197] [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: 12/12/2024] [Revised: 05/03/2025] [Accepted: 05/12/2025] [Indexed: 05/28/2025] Open
Abstract
INTRODUCTION The past two decades have seen a paradigm shift in the surgical treatment of sinonasal malignancies, moving from traditional open approaches to minimally invasive endoscopic techniques. Technological advancements have enabled the use of the endoscopic endonasal transcribriform approach (EETA) for tumors involving the anterior skull base (ASB). This study evaluates the oncologic outcomes of EETA for locally advanced sinonasal malignancies with ASB involvement. METHODS We conducted a retrospective cohort study at a tertiary cancer center, including patients treated with EETA for sinonasal malignancies from January 2012 to January 2024. Data on demographic characteristics, clinical presentations, treatment protocols, and survival outcomes were analyzed. Survival probabilities were assessed using Kaplan-Meier curves, and subgroups comparisons were made using the log rank test. RESULTS Forty-nine patients were included, predominantly with primary tumors (91.8%) and advanced stages (cT3-T4: 89.8%). EETA achieved R0 resection in 82.1% of cases. All eligible patients (88.9%) underwent postoperative radiotherapy, with 97.5% beginning treatment 6-8 weeks after surgery. The mean follow-up duration was 43.2 months. The 5-year overall survival (OS) was 66.5%, disease-free survival (DFS) was 58.7%, and local relapse-free survival (LRFS) was 75%. Patients with olfactory neuroblastoma had significantly higher OS and DFS compared to intestinal-type adenocarcinoma. Margin status significantly impacted survival, with better outcomes observed in patients with clear margins. CONCLUSION EETA offers a viable and effective alternative for treating locally advanced sinonasal malignancies with ASB involvement, achieving acceptable oncologic outcomes with reduced morbidity.
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Affiliation(s)
- Michel Khalaf
- Department of Head Neck & Skull Base Surgery, Gustave Roussy, Villejuif, France
| | - Héloïse De Kermadec
- Department of Head Neck & Skull Base Surgery, Gustave Roussy, Villejuif, France
| | | | | | - Gabriel Garcia
- Department of Diagnostic Radiology, Gustave Roussy, Villejuif, France
| | - François Bidault
- Department of Diagnostic Radiology, Gustave Roussy, Villejuif, France
| | | | - France Nguyen
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France
| | - Stéphane Temam
- Department of Head Neck & Skull Base Surgery, Gustave Roussy, Villejuif, France
| | - Pierre Blanchard
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, France
| | - Damien Bresson
- Université Paris-Saclay, France
- Department of Neurosurgery, Foch Hospital, Suresnes, France
| | - Antoine Moya Plana
- Department of Head Neck & Skull Base Surgery, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, France
- Inserm U981, Gustave Roussy, Villejuif, France
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Chatelet F, Chevret S, Vinciguerra A, Bertazzoni G, Camous D, Ferrari M, Mattavelli D, Turri-Zanoni M, Schreiber A, Taboni S, Rampinelli V, Arosio AD, Piazza C, Battaglia P, Bignami M, Deganello A, Castelnuovo P, Nicolai P, Herman P, Verillaud B. Matching-adjusted indirect comparison of endoscopic and craniofacial resection for the treatment of sinonasal cancer invading the skull base. Eur J Cancer 2025; 220:115382. [PMID: 40154209 DOI: 10.1016/j.ejca.2025.115382] [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: 12/28/2024] [Revised: 02/23/2025] [Accepted: 03/15/2025] [Indexed: 04/01/2025]
Abstract
AIM The aim of this study was to compare the efficacy and safety of endoscopic endonasal approaches (EEA) with craniofacial resection (CFR) for sinonasal cancers invading the skull base, using an unanchored matching-adjusted indirect comparison (MAIC). METHODS A MAIC approach was used to analyse data from two large cohorts: the MUlti-institutional collaborative Study on Endoscopically treated Sinonasal cancers (MUSES) cohort, comprising sinonasal cancer patients treated endoscopically, and a historical CFR cohort reported by Ganly et al. Individual patient data were available only for the first cohort. Patients with olfactory neuroblastomas were excluded. Key prognostic factors were used to match and adjust the two cohorts, minimising selection bias. The primary endpoint was overall survival (OS), with secondary endpoints including recurrence-free survival (RFS), perioperative mortality, complication rates, and resection margins. RESULTS A total of 724 EEA-treated and 334 CFR-treated patients were included. EEA showed significantly improved OS before (HR= 2.33, 95 % CI= 1.88-2.87) and after MAIC adjustment (HR= 1.93, 95 % CI= 1.60-2.34). Observed RFS was higher in the EEA group (HR= 1.39, 95 % CI = 1.14-1.69) but no longer differed after adjustment (HR= 1.06, 95 % CI= 0.91-1.23). EEA was associated with significantly better Disease Specific Survival (HR= 1.71, 95 % CI = 1.39-2.13), lower perioperative mortality (OR= 8.12, 95 % CI= 3.45-36.7) and fewer complications than CFR (OR= 3.68, 95 % CI= 2.47-5.42). CONCLUSION In this MAIC study based on the 2 largest cohorts of sinonasal cancer with skull base invasion, EEA offered comparable oncologic outcomes to CFR with reduced morbidity, supporting it as a valid alternative when performed in expert centres.
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Affiliation(s)
- Florian Chatelet
- Université Paris Cité, ENT and Skull Base Department, Laribosiere Hospital APHP, Paris F-75010, France; Université Paris Cité INSERM CRESS UMR 1153 ECSTRRA team, Biostatistics Department Saint Louis Hospital APHP Paris F-75010, France.
| | - Sylvie Chevret
- Université Paris Cité INSERM CRESS UMR 1153 ECSTRRA team, Biostatistics Department Saint Louis Hospital APHP Paris F-75010, France
| | - Alessandro Vinciguerra
- Université Paris Cité, ENT and Skull Base Department, Laribosiere Hospital APHP, Paris F-75010, France; Division of Otorhinolaryngology, "ASST Lariana", University of Insubria, Como, Italy
| | | | - Domitille Camous
- Université Paris Cité, ENT and Skull Base Department, Laribosiere Hospital APHP, Paris F-75010, France
| | - Marco Ferrari
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Universita ` di Padova", University of Padua, Padua, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Mario Turri-Zanoni
- Division of Otorhinolaryngology, "ASST Lariana", University of Insubria, Como, Italy
| | - Alberto Schreiber
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Stefano Taboni
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Universita ` di Padova", University of Padua, Padua, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Alberto Daniele Arosio
- Division of Otorhinolaryngology, Department of Surgical Specialties, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", Varese, Italy
| | - Cesare Piazza
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Paolo Battaglia
- Division of Otorhinolaryngology, "ASST Lariana", University of Insubria, Como, Italy
| | - Maurizio Bignami
- Division of Otorhinolaryngology, Department of Surgical Specialties, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", Varese, Italy
| | - Alberto Deganello
- Otolaryngology Head and Neck Surgery Department of IRCCS, National Cancer Institute (INT), Milan, Italy
| | - Paolo Castelnuovo
- Division of Otorhinolaryngology, Department of Surgical Specialties, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", Varese, Italy
| | - Piero Nicolai
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Universita ` di Padova", University of Padua, Padua, Italy
| | - Philippe Herman
- Université Paris Cité, ENT and Skull Base Department, Laribosiere Hospital APHP, Paris F-75010, France
| | - Benjamin Verillaud
- Université Paris Cité, ENT and Skull Base Department, Laribosiere Hospital APHP, Paris F-75010, France
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Arosio AD, Coden E, Lambertoni A, Sileo G, Dalfino G, Monti G, Daloiso A, Gaudioso P, Ferrari M, Nicolai P, Castelnuovo P, Bignami M. Surgical margin assessment and prognostic impact in sinonasal cancers: a systematic review and meta-analysis. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2025; 45:S25-S55. [PMID: 40400376 DOI: 10.14639/0392-100x-suppl.1-45-2025-n1127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2025] [Accepted: 03/31/2025] [Indexed: 05/23/2025]
Abstract
Objective Surgery remains a cornerstone in treatment of sinonasal malignancies, but the prognostic role of margin status is controversial. This systematic review and meta-analysis evaluated the prognostic significance of surgical margins in sinonasal cancer and their impact on survival, alongside key challenges in its evaluation. Methods A systematic search in PubMed, Scopus, and Web of Science identified 64 studies (34,120 patients). Results The overall margin infiltration rate was 33.2%, varying widely across studies (4.5-88.2%) and histotypes, and was the highest in adenoid cystic carcinoma (ACC, 61.5%). Meta-analysis of 31 studies showed positive margins were associated with worse survival (overall survival, odds ratio [OR] 2.61; disease-specific survival, OR 5.89; disease-free survival, OR 4.40). Squamous cell carcinoma, olfactory neuroblastoma, and mucosal melanoma had the strongest correlation with margin status, while for ACC and adenocarcinomas statistical significance was not reached. High heterogeneity was noted across studies, alongside inconsistent margin classification, distance thresholds, and use of frozen sections, limiting cross-study comparability. Conclusions This study confirms the prognostic value of surgical margins, but underscores the urgent need for standardised definitions to improve prediction of oncologic outcomes and clinical decision-making.
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Affiliation(s)
- Alberto Daniele Arosio
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Elisa Coden
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Alessia Lambertoni
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Giorgio Sileo
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Gianluca Dalfino
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Giulia Monti
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Antonio Daloiso
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy
- Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale-Università Padua, Padua, Italy
| | - Piergiorgio Gaudioso
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy
- Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale-Università Padua, Padua, Italy
| | - Marco Ferrari
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy
- Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale-Università Padua, Padua, Italy
| | - Piero Nicolai
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy
- Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale-Università Padua, Padua, Italy
| | - Paolo Castelnuovo
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
- Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Maurizio Bignami
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
- Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
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Carsuzaa F, Favier V, Seguin L, Turri-Zanoni M, Camarda AM, Verillaud B, Herman P, Borsetto D, Schreiber A, Taboni S, Rampinelli V, Vinciguerra A, Vural A, Liem X, Busato F, Renard S, Dupin C, Doré M, Graff P, Tao Y, Racadot S, Moya Plana A, Landis BN, Marcy PY, Patron V, de Gabory L, Orlandi E, Ferrari M, Thariat J. Consensus for a postoperative atlas of sinonasal substructures from a modified Delphi study to guide radiotherapy in sinonasal malignancies. Radiother Oncol 2025; 206:110784. [PMID: 39986542 DOI: 10.1016/j.radonc.2025.110784] [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: 08/20/2024] [Revised: 01/30/2025] [Accepted: 02/10/2025] [Indexed: 02/24/2025]
Abstract
BACKGROUND Sinonasal and skull base tumor surgery-related morbidity has been reduced by the use of endoscopic endonasal skull base surgery (EESBS). Postoperative radiation therapy (poRT) requires precise definition of target volumes. To enhance the accuracy of poRT planning, histological and radiological correlations are necessary to locate the tumor attachment on poRT CT scans. An accurate atlas of structures resected or identified during EESBS could serve for the interdisciplinary postoperative management of patients, personalizing poRT by adequate radiation dose delivery. The objective of this study was to achieve a consensual segmentation atlas on CT scan with surgeons practicing EESBS and radiation oncologists. METHODS The sinonasal structures relevant for poRT of sinonasal malignancies were determined by a two-round Delphi process. A rating group of 25 European experts in sinonasal malignancies was set up. Consensual structures emerged and were used to determine the anatomical limits of the retained structures to draft an atlas with expert based relevant structures. The atlas was then critically reviewed, discussed, and edited by another 2 skull base surgeons and 2 radiation oncologists. RESULTS After the two rating rounds, 46 structures obtained a strong agreement, 7 an agreement, 5 were rejected and 5 did not reach consensus. The atlas integrating all the selected structures is presented attached. CONCLUSION Consensual segmentation atlas on CT scan might allow, through careful poRT planning to limit the morbidity of poRT while maintaining good local control. Prospective studies are necessary to validate this potential precision medicine-based approach.
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Affiliation(s)
- Florent Carsuzaa
- Department of Otolaryngology - Head & Neck Surgery, University Hospital of Poitiers, Poitiers, France; LITEC UR15560, University of Poitiers, Poitiers, France.
| | - Valentin Favier
- Department of Otolaryngology - Head & Neck Surgery, Hospital Gui de Chauliac, University Hospital of Montpellier, Montpellier, France; Research-team ICAR, Laboratory of Computer Science, Robotics and Microelectronics of Montpellier (LIRMM), University of Montpellier, French National Centre for Scientific Research (CNRS), Montpellier, France.
| | - Lise Seguin
- Department of Otolaryngology - Head & Neck Surgery, University Hospital of Poitiers, Poitiers, France
| | - Mario Turri-Zanoni
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Lariana, Como, Italy
| | - Anna-Maria Camarda
- Clinical Department, National Center for Oncological Hadrontherapy (Fondazione CNAO), Pavia, Italy; Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Benjamin Verillaud
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - Philippe Herman
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - Daniele Borsetto
- Department of ENT, Cambridge University Hospitals NHS Trust, United Kingdom
| | - Alberto Schreiber
- Unit of Otorhinolaryngology Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Taboni
- Section of Otorhinolaryngology Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | | | - Alperen Vural
- Department of Otolaryngology - Head & Neck Surgery, Istanbul University Cerrahpasa - Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Xavier Liem
- Department of Radiation Oncology, Oscar Lambret Center, Lille, France
| | - Fabio Busato
- Department of Radiation Oncology, Abano Terme Hospital, Padua, Italy
| | - Sophie Renard
- Department of Radiation Oncology, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - Charles Dupin
- Department of Radiation Oncology, Bordeaux University Hospital, Bordeaux, France; Bordeaux University, BRIC (BoRdeaux Institute of OnCology), UMR1312, INSERM, University of Bordeaux, Bordeaux, France
| | - Mélanie Doré
- Department of Radiation Oncology, Institute de cancérologie de l'Ouest (ICO) centre René-Gauducheau, Saint-Herblain, France
| | - Pierre Graff
- Department of Radiation Oncology, Institut Curie, PSL Research University, Paris - Saint Cloud-Orsay, France
| | - Yungan Tao
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France
| | - Séverine Racadot
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Antoine Moya Plana
- Department of Otolaryngology - Head & Neck Surgery, Gustave Roussy, Villejuif, France
| | - Basile N Landis
- Rhinology-Olfactory Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - Pierre-Yves Marcy
- PolyClinics ELSAN Group, Medipole Sud, Quartier Quiez, 83189 Ollioules, France
| | - Vincent Patron
- Department of Otolaryngology - Head & Neck Surgery, University Hospital of Caen, Caen, France
| | - Ludovic de Gabory
- Department of Otolaryngology and Head & Neck Surgery, Bordeaux University Hospital, Bordeaux, France
| | - Ester Orlandi
- Clinical Department, National Center for Oncological Hadrontherapy (Fondazione CNAO), Pavia, Italy
| | - Marco Ferrari
- Section of Otorhinolaryngology Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Juliette Thariat
- Centre François Baclesse, Comprehensive Cancer Center, Caen, France; Laboratoire de physique Corpusculaire IN2P3/ENSICAEN/CNRS UMR 6534, Normandie Université, Caen France
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Parys QA, De Witte M, Hauben E, Clement PM, Hermans R, Decramer T, van Loon J, Nuyts S, Jorissen M, Vander Poorten V, Van Gerven L. Long-term outcomes of endoscopic resection and tailored adjuvant radiotherapy for sinonasal intestinal-type adenocarcinoma: a historical single-center cohort study in 200 patients. Front Oncol 2025; 15:1522113. [PMID: 40224179 PMCID: PMC11985511 DOI: 10.3389/fonc.2025.1522113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2024] [Accepted: 03/10/2025] [Indexed: 04/15/2025] Open
Abstract
Background Sinonasal intestinal-type adenocarcinoma (ITAC) is a rare disease entity. In contrast to most previous studies, this cohort study consists of a substantial number of uniformly treated patients undergoing endoscopic surgery and adjuvant radiotherapy and provides updated insights into survival outcomes and tumor and treatment-related prognostic factors. Material and methods We retrospectively analyzed the medical records of 200 patients primarily treated for ITAC between 1992 and 2022 in our tertiary referral center. Descriptive statistics were applied using Kaplan-Meier method. Cox models were used for univariable and multivariable data analysis. Results The 5-year overall survival (OS), disease-specific survival (DSS), and local recurrence-free survival (LRFS) rates were 71.4%, 85.1%, and 55.2% respectively. At 10 years, the numbers decreased to 48.2%, 76.2%, and 32.2% respectively. Significant differences were found in OS and DSS between T-groups. Poorly differentiated tumors had decreased DSS compared to well-differentiated tumors (HR: 3.38 [95% CI: 1.20-9.51], p=.0209). Signet-cell differentiation was associated with the poorest survival among poorly differentiated tumors although not reaching significance. In 34.0% of patients, there was local recurrence, with half of the cases detected within the first two years of follow-up but over 10% of recurrence occurring after 10 years. Positive surgical margins (HR: 2.95 [95% CI: 1.29-6.74], p=.0106), local recurrence (HR: 12.28 [95% CI: 5.59-26.99], p<.0001), and distant metastasis (HR: 41.17 [95% CI: 21.58-78.55], p<.0001) negatively affected DSS. Distant metastasis occurred more frequently in poorly differentiated tumors (25.6%) compared to moderately differentiated (9.5%) and well-differentiated tumors (2.5%) (p=.002). Conclusions This extensive study focusing on sinonasal ITAC primarily managed through endoscopic resection and radiotherapy, demonstrates that T-classification and tumor differentiation are independent prognostic factors influencing survival. Furthermore, local recurrence, distant metastasis, and positive surgical margins negatively affect OS and DSS.
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Affiliation(s)
- Quentin-Alexandre Parys
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Matthias De Witte
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Esther Hauben
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Paul M. Clement
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Robert Hermans
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Thomas Decramer
- Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
- Research Group Experimental Neurosurgery and Neuroanatomy and Leuven Brain Institute, Catholic University of Leuven, Leuven, Belgium
| | - Johannes van Loon
- Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
- Research Group Experimental Neurosurgery and Neuroanatomy and Leuven Brain Institute, Catholic University of Leuven, Leuven, Belgium
| | - Sandra Nuyts
- Department of Radiotherapy–Oncology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Experimental Radiotherapy, Department of Oncology, Catholic University 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
- Section of Head and Neck Oncology, Department of Oncology, Catholic University Leuven, Leuven, Belgium
| | - Laura Van Gerven
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Neurosciences, Experimental Otorhinolaryngology, Rhinology Research, Catholic University Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Catholic University Leuven, Leuven, Belgium
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Ghi MG, Bossi P, Bonomo P, Nicolai P. Editorial: Understanding and treating rare nasal and paranasal sinus cancers. Front Oncol 2025; 15:1573770. [PMID: 40098705 PMCID: PMC11911369 DOI: 10.3389/fonc.2025.1573770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2025] [Accepted: 02/14/2025] [Indexed: 03/19/2025] Open
Affiliation(s)
- Maria Grazia Ghi
- Oncology Unit 2, Veneto Institute of Oncology (IRCCS), Padua, Italy
| | - Paolo Bossi
- Medical Oncology and Hematology Unit, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Pierluigi Bonomo
- Department of Radiation Oncology, Careggi University Hospital, Florence, Italy
| | - Piero Nicolai
- Otorhinolaryngology and Head and Neck Unit, Department of Neurosciences, Azienda Ospedale Università di Padova, Padua, Italy
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Ferri A, Bellinato M, Bianchi B, Arcuri F, Perlangeli G, Bergonzani M, Ferrari S. Endoscopic-Assisted Maxillectomy: A Combined Approach for the Management of Maxillary Malignant Tumors. Indian J Otolaryngol Head Neck Surg 2025; 77:1521-1529. [PMID: 40093496 PMCID: PMC11909345 DOI: 10.1007/s12070-025-05370-2] [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: 11/14/2024] [Accepted: 01/19/2025] [Indexed: 03/19/2025] Open
Abstract
Maxillary sinus cancer presents unique challenges due to its slow growth and concealed location, often leading to delayed diagnosis and advanced stage at presentation. Wide resection, including maxillectomy, is frequently necessary for curative treatment. However, achieving clear resection margins while preserving function and aesthetics remains crucial. This article evaluates a combined surgical approach for maxillectomy, aiming to optimize oncological outcomes while minimizing morbidity and preserving function and aesthetics. A retrospective evaluation of patients undergoing endoscopic-assisted maxillectomy was conducted, focusing on demographics, tumor characteristics, surgical techniques, and outcomes. Data including operative time, complications, reconstruction methods, and follow-up were collected and analyzed. Ten patients underwent endoscopic-assisted maxillectomy, with favorable outcomes in terms of oncological radicality and functional preservation. Complications were minimal, and all patients achieved R0 margins. Adjuvant therapies were tailored based on individual patient characteristics, with promising survival outcomes and acceptable morbidity. The combined approach offers advantages over traditional methods by providing precise visualization and control in both endonasal and intraoral aspects of the resection. It allows for en-bloc tumor removal with minimal morbidity. Endoscopic-assisted maxillectomy offers a safe and effective approach for achieving optimal oncological outcomes while preserving function and aesthetics. It represents a significant evolution in the management of maxillary tumors, demanding further investigation and refinement.
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Affiliation(s)
- Andrea Ferri
- Maxillofacial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
| | - Micol Bellinato
- Maxillofacial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
| | - Bernardo Bianchi
- Maxillofacial Surgery Division, Surgery Department, IRCSS Policlinico San Martino, Genoa, Italy
| | - Francesco Arcuri
- Maxillofacial Surgery Division, Surgery Department, IRCSS Policlinico San Martino, Genoa, Italy
| | - Giuseppe Perlangeli
- Maxillofacial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
| | - Michela Bergonzani
- Maxillofacial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
- Via Antonio Gramsci, 14 Parma, Parma, Italy
| | - Silvano Ferrari
- Maxillofacial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
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8
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Resteghini C, Baujat B, Bossi P, Franchi A, de Gabory L, Halamkova J, Haubner F, Hardillo JAU, Hermsen MA, Iacovelli NA, Maroldi R, Mattheis S, Moya-Plana A, Nicolai P, Orlandi E, Thariat J, Trama A, van den Brekel MWM, van Herpen CML, Verillaud B, Kinloch E, Licitra L, Even C. Sinonasal malignancy: ESMO-EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up. ESMO Open 2025; 10:104121. [PMID: 39986703 PMCID: PMC11889493 DOI: 10.1016/j.esmoop.2024.104121] [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: 10/01/2024] [Revised: 12/17/2024] [Accepted: 12/18/2024] [Indexed: 02/24/2025] Open
Abstract
•The CPG provides key recommendations and algorithms for managing SMs, excluding mucosal melanoma and soft-tissue sarcomas. •The guideline covers diagnosis, staging, risk assessment, treatment and disease monitoring. •Technological advancements in treatment with RT are discussed with a special focus on particle therapy. •Surgical indications for open and transnasal endoscopic surgery are provided. •Neoadjuvant chemotherapy in high-grade, locally advanced SMs helps to select subjects for conservative treatments.
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Affiliation(s)
- C Resteghini
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - B Baujat
- Department of Otorhinolaryngology Head and Neck Surgery, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris, France
| | - P Bossi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - A Franchi
- Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - L de Gabory
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, France
| | - J Halamkova
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czechia; Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - F Haubner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Munich, LMU Klinikum, Munich, Germany
| | - J A U Hardillo
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - M A Hermsen
- Department of Head and Neck Oncology, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - N A Iacovelli
- Radiation Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Maroldi
- Division of Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - S Mattheis
- Clinic for Ear, Nose and Throat Medicine, Head and Neck Surgery, University Hospital Essen, Essen, Germany
| | - A Moya-Plana
- Department of Head and Neck Surgery, Gustave Roussy Cancer Campus-Paris Saclay University, Villejuif, France
| | - P Nicolai
- Otolaryngology Unit, University of Padova, Padua, Italy
| | - E Orlandi
- Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy; Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - J Thariat
- Department of Radiation Oncology, Centre François Baclesse, Caen, France; Laboratoire de physique Corpusculaire IN2P3/ENSICAEN/CNRS UMR 6534-Normandie Université, Caen, France
| | - A Trama
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M W M van den Brekel
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Amsterdam Center for Language and Communication, University of Amsterdam, Amsterdam, The Netherlands; Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - C M L van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B Verillaud
- Department of Head and Neck Surgery, Lariboisière Hospital, Université Paris Cité, Paris, France
| | - E Kinloch
- Salivary Gland Cancer UK, London, UK
| | - L Licitra
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - C Even
- Department of Head and Neck Cancer, Gustave Roussy Cancer Campus, Villejuif, France
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9
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Ferrari M, Gaudioso P, Taboni S, Contro G, Roccuzzo G, Costantino P, Daly MJ, Chan HHL, Fieux M, Ruaro A, Maroldi R, Signoroni A, Deganello A, Irish JC, Carsuzaa F, Nicolai P. Intraoperative surgical navigation improves margin status in advanced malignancies of the anterior craniofacial area: A prospective observational study with systematic review of the literature and meta-analysis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2025; 51:109514. [PMID: 39662109 DOI: 10.1016/j.ejso.2024.109514] [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: 10/09/2024] [Revised: 11/18/2024] [Accepted: 12/03/2024] [Indexed: 12/13/2024]
Abstract
The current scientific evidence suggests that surgical navigation (SN) can contribute to improve oncologic outcomes in sinonasal and craniofacial surgery. The present study investigated the feasibility of intraoperative SN and its role in improving the outcomes of surgically treated sinonasal and craniofacial tumors. This prospective study compared navigation-guided surgery for sinonasal or craniofacial malignancies with a pair-matched cohort (1:2 matching) of patients operated without SN. A systematic review of the literature was performed. Thirty-five patients who underwent navigation-guided surgery were included. The pair-matched control cohort included 70 patients operated without SN. The margin status analysis demonstrated a lower rate of positive margins (p = 0.013) in the SN group, especially in pT4 (p = 0.034), recurrent (p = 0.024), high-grade tumors (p = 0.043), and endoscopic-assisted open surgery (p = 0.035). The mean preoperative time did not show a significant difference between surgeries performed with or without SN (1.26 vs. 1.23 h, p = 0.445). However, surgeries utilizing SN had a significantly longer median duration compared to those without (8.10 vs. 6.00 h, p = 0.029). A total of 209 patients were included in the meta-analysis; 91 patients (43.5 %) underwent surgery with SN. The results of the meta-analysis showed an improvement in terms of negative margins rate with the use of SN (OR = 2.62; 95%-confidence interval: 1.33-5.17). In conclusion, intraoperative SN can contribute to achieve a clear margin resection, especially in locally advanced tumors, recurrences, highly aggressive histologies, and when endoscopic-assisted open surgery is employed.
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Affiliation(s)
- Marco Ferrari
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale Università Padova, Padua, Italy; Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, Canada.
| | - Piergiorgio Gaudioso
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale Università Padova, Padua, Italy; Oncology and Immunology (PhD Program), Department of Surgery Oncology and Gastroenterology (DiSCOG), University of Padova, Padova, Italy
| | - Stefano Taboni
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale Università Padova, Padua, Italy; Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, Canada
| | - Giacomo Contro
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale Università Padova, Padua, Italy; Technology for Health (PhD program), Department of Information Engineering, University of Brescia, Brescia, Italy
| | - Giuseppe Roccuzzo
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy
| | - Paola Costantino
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy
| | - Michael J Daly
- Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, Ontario, Canada
| | - Harley H L Chan
- Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, Ontario, Canada
| | - Maxime Fieux
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service D'ORL, D'otoneurochirurgie et de Chirurgie Cervico-faciale, F-69310, Pierre Bénite, Université de Lyon, Université Lyon 1, F-69003, Lyon, France
| | - Alessandra Ruaro
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy; Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, Canada; Department of Otolaryngology and Head and Neck Surgery/Surgical Oncology, University Health Network, Toronto, Ontario, Canada
| | - Roberto Maroldi
- Unit of Radiology, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Alberto Signoroni
- Department of Information Engineering, University of Brescia, Brescia, Italy
| | - Alberto Deganello
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Istituto Nazionale Dei Tumori (INT), Milan, Italy
| | - Jonathan C Irish
- Department of Otolaryngology and Head and Neck Surgery/Surgical Oncology, University Health Network, Toronto, Ontario, Canada
| | - Florent Carsuzaa
- Department of Head and Neck Surgery, Poitiers University Hospital, Poitiers, France
| | - Piero Nicolai
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale Università Padova, Padua, Italy
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10
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Bertazzoni G, Vinciguerra A, Camous D, Ferrari M, Mattavelli D, Turri‐Zanoni M, Schreiber A, Taboni S, Rampinelli V, Arosio AD, Verillaud B, Piazza C, Battaglia P, Bignami M, Deganello A, Castelnuovo P, Nicolai P, Herman P. Morbidity of multimodal treatments including endoscopic surgery for sinonasal malignancies: Results of an international collaborative study on 940 patients (MUSES). Head Neck 2025; 47:371-385. [PMID: 39166378 PMCID: PMC11635746 DOI: 10.1002/hed.27916] [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: 01/02/2024] [Revised: 06/18/2024] [Accepted: 07/31/2024] [Indexed: 08/22/2024] Open
Abstract
INTRODUCTION In the management of sinonasal malignancies treatment-induced morbidity and mortality is gaining relevance both for surgical approaches (endoscopic and open resection) and non-surgical therapies. The aim of this multicenter study is to assess complications associated with endoscopic surgery and non-surgical treatments (neoadjuvant and/or adjuvant) for malignant sinonasal tumors. METHODS All patients with nasoethmoidal malignancies treated with curative intent with endoscopic or endoscopic-assisted surgery at three referral centers with uniform management policies were included. Neo- and/or adjuvant (chemo)radiotherapy was administered according to histology and pathological report. Demographics, treatment characteristics, and complications related both to the surgical and non-surgical approaches were retrieved. The data were analyzed with univariate and multivariate statistics to assess independent predictors of complications. RESULTS Nine hundred and forty patients were included, 643 males (68%) and 297 females (32%). A total of 225 complications were identified in 187 patients (19.9%): cerebrospinal fluid (CSF) leak (3.5%), mucocele (2.3%), surgical site bleeding (2.0%), epiphora (2.0%), and radionecrosis (2.0%) were the most common. Treatment-related mortality was 0.4%. Variables independently associated with complications at multivariate analysis were principally dural resection (OR 1.92), cranioendoscopic or multiportal resection (OR 2.93), dural repair with multilayer technique with less than three layers (OR 2.17), and graft different from iliotibial tract (OR 3.29). CONCLUSION Our study shows that modern endoscopic treatments and radiotherapy for sinonasal malignancies are associated with limited morbidity and treatment-related mortality. CSF leak and radionecrosis, although rare, remain the most frequent complications and should be further addressed by future research efforts.
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Affiliation(s)
| | - Alessandro Vinciguerra
- Department of OtorhinolaryngologyLariboisiere University Hospital, APHP Nord – Université De ParisParisFrance
| | - Domitille Camous
- Department of OtorhinolaryngologyLariboisiere University Hospital, APHP Nord – Université De ParisParisFrance
| | - Marco Ferrari
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, Azienda Ospedale Università di PadovaUniversity of PaduaPaduaItaly
| | - Davide Mattavelli
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public HealthASST Spedali Civili di Brescia, University of BresciaBresciaItaly
| | - Mario Turri‐Zanoni
- Division of Otorhinolaryngology, Department of Biotechnology and Life SciencesUniversity of Insubria, ASST LarianaComoItaly
| | - Alberto Schreiber
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public HealthASST Spedali Civili di Brescia, University of BresciaBresciaItaly
| | - Stefano Taboni
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, Azienda Ospedale Università di PadovaUniversity of PaduaPaduaItaly
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public HealthASST Spedali Civili di Brescia, University of BresciaBresciaItaly
| | - Alberto Daniele Arosio
- Division of Otorhinolaryngology, Department of Biotechnology and Life SciencesUniversity of Insubria, ASST Sette LaghiVareseItaly
| | - Benjamin Verillaud
- Department of OtorhinolaryngologyLariboisiere University Hospital, APHP Nord – Université De ParisParisFrance
| | - Cesare Piazza
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public HealthASST Spedali Civili di Brescia, University of BresciaBresciaItaly
| | - Paolo Battaglia
- Division of Otorhinolaryngology, Department of Biotechnology and Life SciencesUniversity of Insubria, ASST LarianaComoItaly
| | - Maurizio Bignami
- Division of Otorhinolaryngology, Department of Biotechnology and Life SciencesUniversity of Insubria, ASST Sette LaghiVareseItaly
| | - Alberto Deganello
- Otolaryngology Head and Neck Surgery Department of IRCCSNational Cancer Institute (INT)MilanItaly
| | - Paolo Castelnuovo
- Division of Otorhinolaryngology, Department of Biotechnology and Life SciencesUniversity of Insubria, ASST Sette LaghiVareseItaly
| | - Piero Nicolai
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, Azienda Ospedale Università di PadovaUniversity of PaduaPaduaItaly
| | - Philippe Herman
- Department of OtorhinolaryngologyLariboisiere University Hospital, APHP Nord – Université De ParisParisFrance
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11
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Daloiso A, Gaudioso P, Vinciguerra A, Turri‐Zanoni M, Testa G, Cazzador D, Lambertoni A, Arosio AD, Contro G, Taboni S, Rampinelli V, Piazza C, Bignami M, Emanuelli E, Battaglia P, Bossi P, Herman P, Castelnuovo P, Hanna EY, Nicolai P, Mattavelli D, Ferrari M. Ectopic olfactory neuroblastoma is associated with increased frequency of syndrome of inappropriate antidiuretic hormone secretion and reduced disease control: Case series with systematic review and pooled analysis. Int Forum Allergy Rhinol 2025; 15:45-67. [PMID: 39661032 PMCID: PMC11697229 DOI: 10.1002/alr.23502] [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: 10/10/2024] [Revised: 11/23/2024] [Accepted: 11/26/2024] [Indexed: 12/12/2024]
Abstract
INTRODUCTION Olfactory neuroblastoma (ONB) is a rare malignant tumor originating from the olfactory neuroepithelium, typically within the sinonasal cavity. Cases of ONB originating outside of the olfactory cleft area are extremely rare and are referred to as "ectopic" (eONB), in contrast to "orthotopic" tumors (oONB). ONB has been associated with paraneoplastic syndromes (PNSs), including the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This study investigate the association between eONB and SIADH and compared the prognosis of eONB to oONB. METHODS A systematic literature review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted, focusing on studies reporting eONB and oONB associated with SIADH. Data from four newly identified eONB cases were reported and a pooled analysis was performed. Statistical analyses were conducted to evaluate the prevalence of SIADH in eONB and oONB and to compare clinical outcomes in the two groups. RESULTS eONB had a significantly higher prevalence of SIADH (18.3%) compared to oONB (2.0%; p < 0.0001). Patients with eONB were younger, with a slight predominance of females. Recurrence-free survival and time-to-recurrence of eONB were worse than oONB, independently of other prognosticators. CONCLUSIONS eONB is associated with a significantly higher incidence of SIADH than oONB, suggesting distinct biological characteristics. Moreover, patients with eONB had worse prognostic outcomes. Further research is needed to understand the underlying mechanisms and improve management strategies for eONB.
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Affiliation(s)
- Antonio Daloiso
- Section of Otorhinolaryngology—Head and Neck SurgeryDepartment of NeuroscienceUniversity of PadovaPadovaItaly
- Unit of Otorhinolaryngology—Head and Neck SurgeryAzienda Ospedale‐Università PadovaPadovaItaly
| | - Piergiorgio Gaudioso
- Section of Otorhinolaryngology—Head and Neck SurgeryDepartment of NeuroscienceUniversity of PadovaPadovaItaly
- Unit of Otorhinolaryngology—Head and Neck SurgeryAzienda Ospedale‐Università PadovaPadovaItaly
| | - Alessandro Vinciguerra
- Otorhinolaryngology and Skull Base CenterAP‐HP, Hospital LariboisièreParisFrance
- Department of Otolaryngology—Head and Neck SurgeryASST LarianaOspedale Sant'AnnaUniversity of InsubriaComoItaly
| | - Mario Turri‐Zanoni
- Department of Otolaryngology—Head and Neck SurgeryASST LarianaOspedale Sant'AnnaUniversity of InsubriaComoItaly
- Division of OtolaryngologyDepartment of Biotechnology and LifeSciencesUniversity of Insubria, Ospedale di Circolo e Fondazione MacchiVareseItaly
| | - Gabriele Testa
- Unit of Otorhinolaryngology—Head and Neck SurgeryASST Spedali Civili BresciaDepartment of Medical and Surgical SpecialtiesRadiological Sciences and Public HealthUniversity of BresciaBresciaItaly
| | - Diego Cazzador
- Unit of Otorhinolaryngology—Head and Neck SurgeryAzienda Ospedale‐Università PadovaPadovaItaly
| | - Alessia Lambertoni
- Division of OtolaryngologyDepartment of Biotechnology and LifeSciencesUniversity of Insubria, Ospedale di Circolo e Fondazione MacchiVareseItaly
| | - Alberto Daniele Arosio
- Division of OtolaryngologyDepartment of Biotechnology and LifeSciencesUniversity of Insubria, Ospedale di Circolo e Fondazione MacchiVareseItaly
| | - Giacomo Contro
- Unit of Otorhinolaryngology—Head and Neck SurgeryAzienda Ospedale‐Università PadovaPadovaItaly
| | - Stefano Taboni
- Unit of Otorhinolaryngology—Head and Neck SurgeryAzienda Ospedale‐Università PadovaPadovaItaly
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology—Head and Neck SurgeryASST Spedali Civili BresciaDepartment of Medical and Surgical SpecialtiesRadiological Sciences and Public HealthUniversity of BresciaBresciaItaly
| | - Cesare Piazza
- Unit of Otorhinolaryngology—Head and Neck SurgeryASST Spedali Civili BresciaDepartment of Medical and Surgical SpecialtiesRadiological Sciences and Public HealthUniversity of BresciaBresciaItaly
| | - Maurizio Bignami
- Division of OtolaryngologyDepartment of Biotechnology and LifeSciencesUniversity of Insubria, Ospedale di Circolo e Fondazione MacchiVareseItaly
| | - Enzo Emanuelli
- Otolaringology UnitCa’ Foncello HospitalLocal Health Unit N.2 “Marca Trevigiana”TrevisoItaly
| | - Paolo Battaglia
- Department of Otolaryngology—Head and Neck SurgeryASST LarianaOspedale Sant'AnnaUniversity of InsubriaComoItaly
- Division of OtolaryngologyDepartment of Biotechnology and LifeSciencesUniversity of Insubria, Ospedale di Circolo e Fondazione MacchiVareseItaly
| | - Paolo Bossi
- Medical Oncology and Hematology UnitIRCCS Humanitas Research HospitalMilanItaly
- Department of Biomedical SciencesHumanitas UniversityMilanItaly
| | - Philippe Herman
- Otorhinolaryngology and Skull Base CenterAP‐HP, Hospital LariboisièreParisFrance
| | - Paolo Castelnuovo
- Division of OtolaryngologyDepartment of Biotechnology and LifeSciencesUniversity of Insubria, Ospedale di Circolo e Fondazione MacchiVareseItaly
| | - Ehab Y. Hanna
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Piero Nicolai
- Section of Otorhinolaryngology—Head and Neck SurgeryDepartment of NeuroscienceUniversity of PadovaPadovaItaly
- Unit of Otorhinolaryngology—Head and Neck SurgeryAzienda Ospedale‐Università PadovaPadovaItaly
| | - Davide Mattavelli
- Unit of Otorhinolaryngology—Head and Neck SurgeryASST Spedali Civili BresciaDepartment of Medical and Surgical SpecialtiesRadiological Sciences and Public HealthUniversity of BresciaBresciaItaly
| | - Marco Ferrari
- Section of Otorhinolaryngology—Head and Neck SurgeryDepartment of NeuroscienceUniversity of PadovaPadovaItaly
- Unit of Otorhinolaryngology—Head and Neck SurgeryAzienda Ospedale‐Università PadovaPadovaItaly
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12
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Wenda N, Wagner S, Fruth K, Fisseler-Eckhoff A, Gosepath J. Differentiating Sinonasal Tumor Entities with Fluorescein-Enhanced Confocal Laser Endomicroscopy: A Step Forward in Precision Diagnostics. Cancers (Basel) 2024; 16:4245. [PMID: 39766144 PMCID: PMC11674328 DOI: 10.3390/cancers16244245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Revised: 12/11/2024] [Accepted: 12/15/2024] [Indexed: 01/11/2025] Open
Abstract
Background/Objectives: Sinonasal malignancies are rare and highly diverse cancers that pose significant diagnostic challenges due to their variable histological features and complex anatomical locations. Accurate diagnosis is critical for guiding treatment, yet conventional methods often require multiple biopsies. This study aimed to evaluate the potential of confocal laser endomicroscopy (CLE) for real-time imaging of sinonasal tumors to characterize specific features of different entities and improve diagnostic precision. Methods: Ten patients with various sinonasal malignancies, including squamous cell carcinoma, adenocarcinoma, sinonasal undifferentiated carcinoma, olfactory neuroblastoma, sinonasal mucosal melanoma, and endonasal lymphoma, were examined using CLE during diagnostic endoscopy. CLE images were compared descriptively with histopathological cross-sections to identify unique imaging patterns for each tumor type. Results: CLE was feasible across all cases, with high-quality images obtained despite anatomical challenges in some cases. Characteristic features, such as vascular clusters in undifferentiated carcinoma, mucin-filled bubbles in adenocarcinoma, and small round cells in neuroblastoma, were identified and corresponded well with histopathological findings. CLE also helped guide biopsies by revealing areas with diagnostic relevance. Conclusions: CLE demonstrates promise as an adjunct diagnostic tool in sinonasal malignancies, offering real-time imaging that correlates with histopathological findings and aids in targeted biopsies. While this study provides preliminary insights into the utility of CLE, further research with larger cohorts and statistical validation is necessary to establish its diagnostic reliability and broader clinical application.
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Affiliation(s)
- Nina Wenda
- Department of Otolaryngology, Head and Neck Surgery, Helios HSK Wiesbaden, 65199 Wiesbaden, Germany; (K.F.); (J.G.)
| | - Sebastian Wagner
- Department of Pathology, Helios HSK Wiesbaden, 65199 Wiesbaden, Germany; (S.W.); (A.F.-E.)
| | - Kai Fruth
- Department of Otolaryngology, Head and Neck Surgery, Helios HSK Wiesbaden, 65199 Wiesbaden, Germany; (K.F.); (J.G.)
| | | | - Jan Gosepath
- Department of Otolaryngology, Head and Neck Surgery, Helios HSK Wiesbaden, 65199 Wiesbaden, Germany; (K.F.); (J.G.)
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13
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Gaudioso P, Contro G, Taboni S, Costantino P, Visconti F, Sozzi M, Borsetto D, Sharma R, De Almeida J, Verillaud B, Vinciguerra A, Carsuzaa F, Thariat J, Vural A, Schreiber A, Mattavelli D, Rampinelli V, Battaglia P, Turri-Zanoni M, Karligkiotis A, Pistochini A, Arosio AD, Lambertoni A, Nair D, Dallan I, Bonomo P, Molteni M, El Khouzai B, Busato F, Zanoletti E, Krengli M, Orlandi E, Nicolai P, Ferrari M. Intraoperative surgical navigation as a precision medicine tool in sinonasal and craniofacial oncologic surgery. Oral Oncol 2024; 157:106979. [PMID: 39121797 DOI: 10.1016/j.oraloncology.2024.106979] [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: 04/17/2024] [Revised: 08/01/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024]
Abstract
INTRODUCTION Recent evidence supports the efficacy of surgical navigation (SN) in improving outcomes of sinonasal and craniofacial oncologic surgery. This study aims to demonstrate the utility of SN as a tool for integrating surgical, radiologic, and pathologic information. Additionally, a system for recording and mapping biopsy samples has been devised to facilitate sharing of spatial information. MATERIALS AND METHODS SN was utilized for biopsy mapping in 10 sinonasal/craniofacial oncologic procedures. Twenty-five raters with experience in anterior skull base oncology were interviewed to identify 15 anatomical structures in preoperative imaging, relying on topographical descriptions and surgical video clips. The difference in the localization of anatomical structures by raters was analyzed, using the SN-mapped coordinates as a reference (this difference was defined as spatial error). RESULTS The analysis revealed an average spatial error of 9.0 mm (95 % confidence interval: 8.3-9.6 mm), with significant differences between surgeons and radiation oncologists (7.9 mm vs 12.5 mm, respectively, p < 0.0001). The proposed model for transferring SN-mapped coordinates can serve as a tool for consultation in multidisciplinary discussions and radiotherapy planning. CONCLUSIONS The current standard method to evaluate disease extension and margin status is associated with a spatial error approaching 1 cm, which could affect treatment precision and outcomes. The study emphasizes the potential of SN in increasing spatial precision and information sharing. Further research is needed to incorporate this method into a multidisciplinary workflow and measure its impact on outcomes.
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Affiliation(s)
- Piergiorgio Gaudioso
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy; Oncology and Immunology (PhD Program), Department of Surgery Oncology and Gastroenterology (DiSCOG), University of Padova, Padova, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale Università Padova, Padua, Italy
| | - Giacomo Contro
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale Università Padova, Padua, Italy; Technology for Health (PhD Program), Department of Information Engineering, University of Brescia, Brescia, Italy
| | - Stefano Taboni
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale Università Padova, Padua, Italy; Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, Canada; Artificial Intelligence in Medicine and Innovation in Clinical Research and Methodology (PhD Program), Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Paola Costantino
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Francesca Visconti
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Mosè Sozzi
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Daniele Borsetto
- Department of ENT, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Rishi Sharma
- Department of ENT, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - John De Almeida
- Department of Otolaryngology - Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Benjamin Verillaud
- ENT and Head and Neck Surgery Department, Lariboisiere Hospital, 2 rue Ambroise Paré, 75010 Paris, France; INSERM U1141 "NeuroDiderot", Université Paris Cité, 75010 Paris, France
| | - Alessandro Vinciguerra
- ENT and Head and Neck Surgery Department, Lariboisiere Hospital, 2 rue Ambroise Paré, 75010 Paris, France
| | - Florent Carsuzaa
- Department of Head and Neck Surgery, Poitiers University Hospital, Poitiers, France
| | - Juliette Thariat
- Department of Radiation Oncology, François Baclesse Center, Caen, France
| | - Alperen Vural
- Department of Otorhinolaryngology, Istanbul University Cerrahpasa - Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Alberto Schreiber
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia - "ASST Spedali Civili di Brescia", Brescia, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia - "ASST Spedali Civili di Brescia", Brescia, Italy
| | - Vittorio Rampinelli
- Technology for Health (PhD Program), Department of Information Engineering, University of Brescia, Brescia, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia - "ASST Spedali Civili di Brescia", Brescia, Italy
| | - Paolo Battaglia
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Mario Turri-Zanoni
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Apostolos Karligkiotis
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Andrea Pistochini
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy; Department of Biotechnology and Life Sciences, Head and Neck Surgery and Forensic Dissection Research Center (HNS&FDRc), University of Insubria, Varese, Italy
| | - Alberto Daniele Arosio
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Alessia Lambertoni
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Deepa Nair
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha Block, Tata Memorial Hospital, Parel, Homi Bhabha National Institute, 1209, Dr Ernest Borges Marg, Mumbai 400012, India
| | - Iacopo Dallan
- Otolaryngology, Audiology and Phoniatric Operative Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana (AOUP), University of Pisa, Via Paradisa, 2, 56124 Pisa, Italy
| | - Pierluigi Bonomo
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Marinella Molteni
- Department of Radiotherapy, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", Varese, Italy
| | - Badr El Khouzai
- Radiotherapy Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Fabio Busato
- Department of Radiation Oncology, Abano Terme Hospital, Padua, Italy
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale Università Padova, Padua, Italy
| | - Marco Krengli
- Radiotherapy Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padova, 35100 Padua, Italy
| | - Ester Orlandi
- Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy; Clinical Department, National Center for Oncological Hadrontherapy (Fondazione CNAO), Pavia, Italy
| | - Piero Nicolai
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale Università Padova, Padua, Italy
| | - Marco Ferrari
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale Università Padova, Padua, Italy; Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, Canada.
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14
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Novak S, Balatkova Z, Fikova A, Grega M, Kalfert D, Plzak J. Preservation of orbit in tumor invasion through the periorbita in sinonasal malignancy. Eur Arch Otorhinolaryngol 2024; 281:5303-5310. [PMID: 38914815 PMCID: PMC11416355 DOI: 10.1007/s00405-024-08757-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/26/2024] [Indexed: 06/26/2024]
Abstract
OBJECTIVE One of the possible risks of sinonasal malignancy is its possible spread in the orbit. However, there is no clear consensus among the different departments as to whether it is necessary to exenterate the orbit in limited tumorous infiltration of periorbital fat. The purpose of the study was to demonstrate that periorbital infiltration and periorbital fat invasion without involvement of deeper orbital tissues are not the indication of orbital exenteration. MATERIALS AND METHODS Retrospective analysis was performed over a 17-year period of patients undergoing surgical treatment for sinonasal malignancy with histologically verified periorbital infiltration or deeper invasion into the orbit. A total of 32 patients were included in the study. For each group, the following data were analysed: sex, age, preoperative imaging studies, histological findings, site of origin, stage, surgical reconstruction, oncological treatment, survival, cause of death, number of recurrences in the orbit and functional status of preserved eyes. RESULTS Based on our criteria for orbital exenteration, orbital preservation was feasible in 18 patients. Orbital exenteration was performed in 14 patients with deeper tumor infiltration. There was a statistically insignificant difference in survival between the two groups. The 5-year overall survival (OS) was 44% for the orbital preservation group (only 2 patients died from local tumor recurrence) and 34% for the orbital exenteration group. The groups did not differ in other observed factors other than the extent of orbital infiltration. In 11 (61.1%) patients, vision was without significant change after radiation therapy. In 2 (11.1%) patients, visual function was impaired due to diplopia. 5 (27.8%) patients had severely impaired vision due to optic nerve atrophy after radiation therapy. CONCLUSIONS Our results show a relatively high survival rate in the group of patients with orbital preservation with a high chance of vision preservation, which justifies our approach to orbital preservation even in some tumors with periorbital infiltration.
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Affiliation(s)
- Stepan Novak
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, Prague, 150 06, Czech Republic.
| | - Zuzana Balatkova
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, Prague, 150 06, Czech Republic
| | - Alzbeta Fikova
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, Prague, 150 06, Czech Republic
| | - Marek Grega
- Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - David Kalfert
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, Prague, 150 06, Czech Republic
| | - Jan Plzak
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, Prague, 150 06, Czech Republic
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15
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Roccuzzo G, Vyskocil E, Hirtler L, Kandathil SA, Peris-Celda M, Agosti E, Kuan EC, Wang EW, Leong S, Sharma R, Borsetto D, Herman P, Vinciguerra A, Verillaud B, Bresson D, Taboni S, Erovic BM, Vural A, Dallan I, Doglietto F, Schreiber A, Mattavelli D, Rampinelli V, Arosio AD, Battaglia P, Valentini M, Turri-Zanoni M, Pozzi F, Volpi L, Bignami M, Castelnuovo P, Nicolai P, Ferrari M. Endoscopic-assisted transorbital extended orbital exenteration: A multi-institutional preclinical study. Head Neck 2024; 46:2327-2339. [PMID: 38958177 DOI: 10.1002/hed.27858] [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: 02/05/2024] [Revised: 06/17/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Sinonasal malignancies with orbital invasion have dismal prognosis even when treated with orbital exenteration (OE). Sugawara et al. developed a surgical strategy called "extended-OE (EOE)," showing encouraging outcomes. We hypothesized that a similar resection is achievable under endoscopic guidance through the exenterated orbit (endoscopic-EOE). METHODS The study was conducted in three institutions: University of Vienna; Mayo Clinic; University of Insubria; 48 orbital dissections were performed. A questionnaire was developed to evaluate feasibility and safety of each step, scoring from 1 to 10, ("impossible" to "easy," and "high risk" to "low risk," respectively), most likely complication(s) were hypothesized. RESULTS The step-by-step technique is thoroughly described. The questionnaire was answered by 25 anterior skull base surgeons from six countries. Mean, median, range, and interquartile range of both feasibility and safety scores are reported. CONCLUSIONS Endoscopic-EOE is a challenging but feasible procedure. Clinical validation is required to assess real-life outcomes.
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Affiliation(s)
- Giuseppe Roccuzzo
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, Padova, Italy
- Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale-Università Padova, Padova, Italy
- Department of Otorhinolaryngology, General Hospital and Medical University of Vienna, Vienna, Austria
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Erich Vyskocil
- Department of Otorhinolaryngology, General Hospital and Medical University of Vienna, Vienna, Austria
| | - Lena Hirtler
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Sam Augustine Kandathil
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | | | - Edoardo Agosti
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Edward C Kuan
- Department of Otolaryngology - Head & Neck Surgery, University of California Irvine, Irvine, California, USA
| | - Eric W Wang
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Samuel Leong
- Department of Ear, Nose and Throat, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Rishi Sharma
- Department of Otolaryngology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Daniele Borsetto
- Department of Otolaryngology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Philippe Herman
- Otorhinolaryngology and Skull Base Center, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Alessandro Vinciguerra
- Otorhinolaryngology and Skull Base Center, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Benjamin Verillaud
- Otorhinolaryngology and Skull Base Center, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Damien Bresson
- Department of Neurosurgery, Hôpital Lariboisière, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Stefano Taboni
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, Padova, Italy
- Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale-Università Padova, Padova, Italy
| | - Boban M Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital, Vienna, Austria
| | - Alperen Vural
- Department of Otorhinolaryngology, Istanbul University Cerrahpasa - Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Iacopo Dallan
- Department of Otolaryngology - Head and Neck Surgery, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Francesco Doglietto
- Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy
| | - Alberto Schreiber
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Alberto Daniele Arosio
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Paolo Battaglia
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Marco Valentini
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Mario Turri-Zanoni
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Fabio Pozzi
- Department of Neurosurgery, ASST Sette Laghi, Ospedale di Circolo Fondazione Macchi, Varese, Italy
| | - Luca Volpi
- Department of Otolaryngology - Head and Neck Surgery, ASST Lariana, Ospedale Sant'Anna, University of Insubria, Como, Italy
| | - Maurizio Bignami
- Department of Otolaryngology - Head and Neck Surgery, ASST Lariana, Ospedale Sant'Anna, University of Insubria, Como, Italy
| | - Paolo Castelnuovo
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Piero Nicolai
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, Padova, Italy
- Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale-Università Padova, Padova, Italy
| | - Marco Ferrari
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, Padova, Italy
- Unit of Otorhinolaryngology - Head and Neck Surgery, Azienda Ospedale-Università Padova, Padova, Italy
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Riobello C, Sánchez-Fernández P, Córdoba MCC, González-Gutiérrez M, Vivanco B, Cabal VN, Fernández LS, García-Marín R, Codina-Martínez H, Lorenzo-Guerra SL, López F, Hermsen MA, Llorente JL. Next-generation sequencing reveals remarkable genetic stability in primary and corresponding recurrent intestinal-type sinonasal adenocarcinoma. Head Neck 2024; 46:2010-2019. [PMID: 38362701 DOI: 10.1002/hed.27694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/23/2024] [Accepted: 02/06/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Recurrent intestinal-type sinonasal adenocarcinoma (ITAC) can occur several years after primary treatment and with different histology. We aimed to clarify if such recurrences could be second primary tumors and to identify actionable mutations as targets for personalized treatment of recurrent ITAC. METHODS Twelve pairs of primary and recurrent ITAC were histologically examined and analyzed by next-generation sequencing. RESULTS Histological differences between primary and recurrent tumor pairs were observed in five cases. Frequent mutations included TP53, APC, TSC2, ATM, EPHA2, BRCA2, LRP1B, KRAS, and KMT2B. There was 86% concordance of somatic mutations between the tumor pairs, while four cases carried additional mutations in the recurrence. CONCLUSIONS We found all cases to be clonal recurrences and not second primary tumors. Moreover, tumor pairs showed a remarkable genomic stability, suggesting that personalized treatment of a recurrence may be based on actionable molecular genetic targets observed in the primary tumor.
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Affiliation(s)
- Cristina Riobello
- Department of Head and Neck Cancer, Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | | | | | | | - Blanca Vivanco
- Department of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Virginia N Cabal
- Department of Head and Neck Cancer, Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | - Laura Suárez Fernández
- Department of Head and Neck Cancer, Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | - Rocío García-Marín
- Department of Head and Neck Cancer, Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | - Helena Codina-Martínez
- Department of Head and Neck Cancer, Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | - Sara Lucila Lorenzo-Guerra
- Department of Head and Neck Cancer, Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | - Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Mario A Hermsen
- Department of Head and Neck Cancer, Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | - José Luis Llorente
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
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17
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Pecorari G, Motatto GM, Piazza F, Garzaro A, Riva G. Real-Life Prognosis of Sinonasal Tumors. J Pers Med 2024; 14:444. [PMID: 38793026 PMCID: PMC11122094 DOI: 10.3390/jpm14050444] [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: 03/25/2024] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Sinonasal cancer represents a challenging disease because of its difficult diagnosis and different histology. Despite a multidisciplinary evaluation and treatments, a poor prognosis is still present. We retrospectively analyzed patients with sinonasal cancer treated in our institution, paying attention to histology and real-life prognosis. METHODS A total of 51 consecutive patients were included in the study. Clinical features were described. Overall, disease-free, and disease-specific survival (OS, DFS, DSS) according to histology were calculated. Kaplan-Meyer estimator curves were reported. RESULTS The most prevalent primary tumor was squamous cell carcinoma, followed by adenocarcinoma. Global 2- and 5-year OS was 68.80% and 54.58%, respectively. Global 2- and 5-year DFS was 48.53% and 29.56%, while global 2- and 5-year DSS was 82.86% and 74.57%, respectively. The median OS was 74 and 43 months for early- and late-stage cancer, respectively. The Cox multivariate regression analysis did not reveal any statistically significant effects of age, stage, or histology on survival outcomes. CONCLUSIONS The diagnosis is often late and the prognosis poor. An appropriate treatment, which is always quite multimodal, allows us to achieve a global 5-year OS slightly higher than 50%. An adequate diagnosis to increase the percentage of early-stage tumors is mandatory to improve prognosis.
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Affiliation(s)
| | | | | | | | - Giuseppe Riva
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (G.P.); (G.M.M.); (F.P.); (A.G.)
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18
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Consonni D, Stella S, Denaro N, Binazzi A, Dallari B, Rugarli S, Borello F, Coviello E, Mensi C. Survival of Patients with Sinonasal Cancers in a Population-Based Registry, Lombardy, Italy, 2008-2023. Cancers (Basel) 2024; 16:896. [PMID: 38473258 DOI: 10.3390/cancers16050896] [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: 01/18/2024] [Revised: 02/08/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Sinonasal cancers (SNCs) are rare malignancies associated with occupational exposures. The aim of this study was to analyse the survival of SNC patients using data from the population-based SNC registry of the Lombardy region (10 million people), Italy. We included epithelial SNC cases registered in 2008-2020 and followed-up for vital status until 31 July 2023. Multivariate flexible parametric models with time-dependent covariates were fitted to calculate excess hazard ratios (EHRs) and 95% confidence intervals (CIs) of death. Based on 827 cases (553 males, 274 females) and 514 deaths (345 males, 169 females), the 5-year observed survival was 49% and the net survival was 57%. Age had a substantial impact on survival, particularly within the first year (EHR, 1.35; 95% CI, 1.12-1.51 per 10 years). Compared with the nasal cavity, the EHR for paranasal sinuses was 4.70 (95% CI, 2.96-7.47) soon after diagnosis. Compared with squamous cell carcinomas, the EHR was 0.69 (95% CI, 0.52-0.91) for adenocarcinomas, 1.68 (95% CI, 1.20-2.35) for undifferentiated and unspecified carcinomas, and 1.78 (95% CI, 1.07-2.95) for neuroendocrine carcinomas. Age and cancer site showed time-dependent effects on prognosis, especially within the first month after diagnosis. Prognosis was also markedly affected by cancer morphology. No associations were found for gender and period of diagnosis.
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Affiliation(s)
- Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Simona Stella
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Nerina Denaro
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, National Institute for Insurance against Accidents at Work (INAIL), 00143 Rome, Italy
| | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Sabrina Rugarli
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Flavia Borello
- SC Prevenzione e Sicurezza, ATS Milano Città Metropolitana, 20122 Milan, Italy
| | - Enzo Coviello
- Formerly at Epidemiology Service, Local Health Unit, 76123 Barletta, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Kuan EC, Wang EW, Adappa ND, Beswick DM, London NR, Su SY, Wang MB, Abuzeid WM, Alexiev B, Alt JA, Antognoni P, Alonso-Basanta M, Batra PS, Bhayani M, Bell D, Bernal-Sprekelsen M, Betz CS, Blay JY, Bleier BS, Bonilla-Velez J, Callejas C, Carrau RL, Casiano RR, Castelnuovo P, Chandra RK, Chatzinakis V, Chen SB, Chiu AG, Choby G, Chowdhury NI, Citardi MJ, Cohen MA, Dagan R, Dalfino G, Dallan I, Dassi CS, de Almeida J, Dei Tos AP, DelGaudio JM, Ebert CS, El-Sayed IH, Eloy JA, Evans JJ, Fang CH, Farrell NF, Ferrari M, Fischbein N, Folbe A, Fokkens WJ, Fox MG, Lund VJ, Gallia GL, Gardner PA, Geltzeiler M, Georgalas C, Getz AE, Govindaraj S, Gray ST, Grayson JW, Gross BA, Grube JG, Guo R, Ha PK, Halderman AA, Hanna EY, Harvey RJ, Hernandez SC, Holtzman AL, Hopkins C, Huang Z, Huang Z, Humphreys IM, Hwang PH, Iloreta AM, Ishii M, Ivan ME, Jafari A, Kennedy DW, Khan M, Kimple AJ, Kingdom TT, Knisely A, Kuo YJ, Lal D, Lamarre ED, Lan MY, Le H, Lechner M, Lee NY, Lee JK, Lee VH, Levine CG, Lin JC, Lin DT, Lobo BC, Locke T, Luong AU, Magliocca KR, Markovic SN, Matnjani G, et alKuan EC, Wang EW, Adappa ND, Beswick DM, London NR, Su SY, Wang MB, Abuzeid WM, Alexiev B, Alt JA, Antognoni P, Alonso-Basanta M, Batra PS, Bhayani M, Bell D, Bernal-Sprekelsen M, Betz CS, Blay JY, Bleier BS, Bonilla-Velez J, Callejas C, Carrau RL, Casiano RR, Castelnuovo P, Chandra RK, Chatzinakis V, Chen SB, Chiu AG, Choby G, Chowdhury NI, Citardi MJ, Cohen MA, Dagan R, Dalfino G, Dallan I, Dassi CS, de Almeida J, Dei Tos AP, DelGaudio JM, Ebert CS, El-Sayed IH, Eloy JA, Evans JJ, Fang CH, Farrell NF, Ferrari M, Fischbein N, Folbe A, Fokkens WJ, Fox MG, Lund VJ, Gallia GL, Gardner PA, Geltzeiler M, Georgalas C, Getz AE, Govindaraj S, Gray ST, Grayson JW, Gross BA, Grube JG, Guo R, Ha PK, Halderman AA, Hanna EY, Harvey RJ, Hernandez SC, Holtzman AL, Hopkins C, Huang Z, Huang Z, Humphreys IM, Hwang PH, Iloreta AM, Ishii M, Ivan ME, Jafari A, Kennedy DW, Khan M, Kimple AJ, Kingdom TT, Knisely A, Kuo YJ, Lal D, Lamarre ED, Lan MY, Le H, Lechner M, Lee NY, Lee JK, Lee VH, Levine CG, Lin JC, Lin DT, Lobo BC, Locke T, Luong AU, Magliocca KR, Markovic SN, Matnjani G, McKean EL, Meço C, Mendenhall WM, Michel L, Na'ara S, Nicolai P, Nuss DW, Nyquist GG, Oakley GM, Omura K, Orlandi RR, Otori N, Papagiannopoulos P, Patel ZM, Pfister DG, Phan J, Psaltis AJ, Rabinowitz MR, Ramanathan M, Rimmer R, Rosen MR, Sanusi O, Sargi ZB, Schafhausen P, Schlosser RJ, Sedaghat AR, Senior BA, Shrivastava R, Sindwani R, Smith TL, Smith KA, Snyderman CH, Solares CA, Sreenath SB, Stamm A, Stölzel K, Sumer B, Surda P, Tajudeen BA, Thompson LDR, Thorp BD, Tong CCL, Tsang RK, Turner JH, Turri-Zanoni M, Udager AM, van Zele T, VanKoevering K, Welch KC, Wise SK, Witterick IJ, Won TB, Wong SN, Woodworth BA, Wormald PJ, Yao WC, Yeh CF, Zhou B, Palmer JN. International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors. Int Forum Allergy Rhinol 2024; 14:149-608. [PMID: 37658764 DOI: 10.1002/alr.23262] [Show More Authors] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Sinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represent a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology-based topics spanning the field. METHODS In accordance with prior International Consensus Statement on Allergy and Rhinology documents, ICSNT assigned each topic as an Evidence-Based Review with Recommendations, Evidence-Based Review, and Literature Review based on the level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses format, and completed sections underwent a thorough and iterative consensus-building process. The final document underwent rigorous synthesis and review prior to publication. RESULTS The ICSNT document consists of four major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology-based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention. CONCLUSION As an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses.
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Affiliation(s)
- Edward C Kuan
- Departments of Otolaryngology-Head and Neck Surgery and Neurological Surgery, University of California, Irvine, Orange, California, USA
| | - Eric W Wang
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Nithin D Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel M Beswick
- Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Nyall R London
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Sinonasal and Skull Base Tumor Program, Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Shirley Y Su
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Marilene B Wang
- Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Waleed M Abuzeid
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Borislav Alexiev
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Jeremiah A Alt
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Paolo Antognoni
- Division of Radiation Oncology, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Michelle Alonso-Basanta
- Department of Radiation Oncology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Pete S Batra
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Mihir Bhayani
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Diana Bell
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Manuel Bernal-Sprekelsen
- Otorhinolaryngology Department, Surgery and Medical-Surgical Specialties Department, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Christian S Betz
- Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jean-Yves Blay
- Department of Medical Oncology, Centre Léon Bérard, UNICANCER, Université Claude Bernard Lyon I, Lyon, France
| | - Benjamin S Bleier
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Juliana Bonilla-Velez
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Claudio Callejas
- Department of Otolaryngology, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Ricardo L Carrau
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Roy R Casiano
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Paolo Castelnuovo
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Rakesh K Chandra
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Simon B Chen
- Department of Pathology, Stanford University, Stanford, California, USA
| | - Alexander G Chiu
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Garret Choby
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Naweed I Chowdhury
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Martin J Citardi
- Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Marc A Cohen
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Roi Dagan
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida, USA
| | - Gianluca Dalfino
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Iacopo Dallan
- Department of Otolaryngology-Head and Neck Surgery, Pisa University Hospital, Pisa, Italy
| | | | - John de Almeida
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Angelo P Dei Tos
- Section of Pathology, Department of Medicine, University of Padua, Padua, Italy
| | - John M DelGaudio
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Charles S Ebert
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ivan H El-Sayed
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - James J Evans
- Department of Neurological Surgery and Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Christina H Fang
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, New York, USA
| | - Nyssa F Farrell
- Department of Otolaryngology-Head and Neck Surgery, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Marco Ferrari
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Nancy Fischbein
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Adam Folbe
- Department of Otolaryngology-Head and Neck Surgery, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | - Wytske J Fokkens
- Department of Otorhinolaryngology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Meha G Fox
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | | | - Gary L Gallia
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Paul A Gardner
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Mathew Geltzeiler
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Christos Georgalas
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Nicosia Medical School, Nicosia, Cyprus
| | - Anne E Getz
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA
| | - Satish Govindaraj
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Stacey T Gray
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Jessica W Grayson
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Bradley A Gross
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jordon G Grube
- Department of Otolaryngology-Head and Neck Surgery, Albany Medical Center, Albany, New York, USA
| | - Ruifeng Guo
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Patrick K Ha
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Ashleigh A Halderman
- Department of Otolaryngology-Head and Neck Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Richard J Harvey
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of South Wales, Sydney, New South Wales, Australia
| | - Stephen C Hernandez
- Department of Otolaryngology-Head and Neck Surgery, LSU Health Sciences Center, New Orleans, Louisiana, USA
| | - Adam L Holtzman
- Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Claire Hopkins
- Department of Otolaryngology-Head and Neck Surgery, Guys and St Thomas' Hospital, London, UK
| | - Zhigang Huang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Zhenxiao Huang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Ian M Humphreys
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Peter H Hwang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Alfred M Iloreta
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Masaru Ishii
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael E Ivan
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Aria Jafari
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - David W Kennedy
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mohemmed Khan
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Adam J Kimple
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Todd T Kingdom
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA
| | - Anna Knisely
- Department of Otolaryngology, Head and Neck Surgery, Swedish Medical Center, Seattle, Washington, USA
| | - Ying-Ju Kuo
- Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Devyani Lal
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Eric D Lamarre
- Head and Neck Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ming-Ying Lan
- Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hien Le
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Matt Lechner
- UCL Division of Surgery and Interventional Science and UCL Cancer Institute, University College London, London, UK
| | - Nancy Y Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jivianne K Lee
- Department of Head and Neck Surgery, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
| | - Victor H Lee
- Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Corinna G Levine
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jin-Ching Lin
- Department of Radiation Oncology, Changhua Christian Hospital, Changhua, Taiwan
| | - Derrick T Lin
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Brian C Lobo
- Department of Otolaryngology-Head and Neck Surgery, University of Florida, Gainesville, Florida, USA
| | - Tran Locke
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Amber U Luong
- Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Kelly R Magliocca
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Svetomir N Markovic
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Gesa Matnjani
- Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Erin L McKean
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Cem Meço
- Department of Otorhinolaryngology, Head and Neck Surgery, Ankara University Medical School, Ankara, Turkey
- Department of Otorhinolaryngology Head and Neck Surgery, Salzburg Paracelsus Medical University, Salzburg, Austria
| | - William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida, USA
| | - Loren Michel
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Shorook Na'ara
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Piero Nicolai
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Daniel W Nuss
- Department of Otolaryngology-Head and Neck Surgery, LSU Health Sciences Center, New Orleans, Louisiana, USA
| | - Gurston G Nyquist
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Gretchen M Oakley
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Richard R Orlandi
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Peter Papagiannopoulos
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Zara M Patel
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - David G Pfister
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jack Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alkis J Psaltis
- Department of Otolaryngology-Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Mindy R Rabinowitz
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Murugappan Ramanathan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ryan Rimmer
- Department of Otolaryngology-Head and Neck Surgery, Yale University, New Haven, Connecticut, USA
| | - Marc R Rosen
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Olabisi Sanusi
- Department of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Zoukaa B Sargi
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Philippe Schafhausen
- Department of Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Ahmad R Sedaghat
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Brent A Senior
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Raj Shrivastava
- Department of Neurosurgery and Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Raj Sindwani
- Head and Neck Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Timothy L Smith
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Kristine A Smith
- Department of Otolaryngology-Head and Neck Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Carl H Snyderman
- Departments of Otolaryngology-Head and Neck Surgery and Neurological Surgery, University of California, Irvine, Orange, California, USA
| | - C Arturo Solares
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Satyan B Sreenath
- Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana, USA
| | - Aldo Stamm
- São Paulo ENT Center (COF), Edmundo Vasconcelos Complex, São Paulo, Brazil
| | - Katharina Stölzel
- Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Baran Sumer
- Department of Otolaryngology-Head and Neck Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Pavol Surda
- Department of Otolaryngology-Head and Neck Surgery, Guys and St Thomas' Hospital, London, UK
| | - Bobby A Tajudeen
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | | | - Brian D Thorp
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Charles C L Tong
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Raymond K Tsang
- Department of Otolaryngology-Head and Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Justin H Turner
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mario Turri-Zanoni
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Aaron M Udager
- Department of Pathology, Michigan Center for Translational Pathology, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Thibaut van Zele
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - Kyle VanKoevering
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Kevin C Welch
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sarah K Wise
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ian J Witterick
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Tae-Bin Won
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Stephanie N Wong
- Division of Otorhinolaryngology, Department of Surgery, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Bradford A Woodworth
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Peter-John Wormald
- Department of Otolaryngology-Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - William C Yao
- Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Chien-Fu Yeh
- Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Bing Zhou
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing, China
| | - James N Palmer
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Locatelli D, Veiceschi P, Arosio AD, Agosti E, Peris-Celda M, Castelnuovo P. 360 Degrees Endoscopic Access to and Through the Orbit. Adv Tech Stand Neurosurg 2024; 50:231-275. [PMID: 38592533 DOI: 10.1007/978-3-031-53578-9_8] [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] [Indexed: 04/10/2024]
Abstract
The treatment of pathologies located within and surrounding the orbit poses considerable surgical challenges, due to the intricate presence of critical neurovascular structures in such deep, confined spaces. Historically, transcranial and craniofacial approaches have been widely employed to deal with orbital pathologies. However, recent decades have witnessed the emergence of minimally invasive techniques aimed at reducing morbidity. Among these techniques are the endoscopic endonasal approach and the subsequently developed endoscopic transorbital approach (ETOA), encompassing both endonasal and transpalpebral approaches. These innovative methods not only facilitate the management of intraorbital lesions but also offer access to deep-seated lesions within the anterior, middle, and posterior cranial fossa via specific transorbital and endonasal corridors. Contemporary research indicates that ETOAs have demonstrated exceptional outcomes in terms of morbidity rates, cosmetic results, and complication rates. This study aims to provide a comprehensive description of endoscopic-assisted techniques that enable a 360° access to the orbit and its surrounding regions. The investigation will delve into indications, advantages, and limitations associated with different approaches, while also drawing comparisons between endoscopic approaches and traditional microsurgical transcranial approaches.
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Affiliation(s)
- Davide Locatelli
- Division of Neurosurgery, Department of Biotechnology and Life Sciences, "Ospedale di Circolo e Fondazione Macchi", University of Insubria, Varese, Italy
- Head and Neck and Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
- Research Center for Pituitary Adenoma and Sellar Pathology, University of Insubria, Varese, Italy
| | - Pierlorenzo Veiceschi
- Division of Neurosurgery, Department of Biotechnology and Life Sciences, "Ospedale di Circolo e Fondazione Macchi", University of Insubria, Varese, Italy
| | - Alberto Daniele Arosio
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, "Ospedale di Circolo e Fondazione Macchi", University of Insubria, Varese, Italy
| | - Edoardo Agosti
- Division of Neurosurgery, Department of Biotechnology and Life Sciences, "Ospedale di Circolo e Fondazione Macchi", University of Insubria, Varese, Italy
- Unit of Neurosurgery, Spedali Civili Hospital, Brescia, Italy
| | - Maria Peris-Celda
- Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, MN, USA
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
| | - Paolo Castelnuovo
- Head and Neck and Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
- Research Center for Pituitary Adenoma and Sellar Pathology, University of Insubria, Varese, Italy
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, "Ospedale di Circolo e Fondazione Macchi", University of Insubria, Varese, Italy
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21
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Nomura M. Definitive treatment for head and neck mucosal melanoma. Jpn J Clin Oncol 2023; 53:1112-1118. [PMID: 37609679 DOI: 10.1093/jjco/hyad109] [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: 04/29/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
Head and neck mucosal melanoma is a rare clinical subtype of melanoma or head and neck cancer. Mucosal melanoma is aetiologically and molecularly distinct from cutaneous melanoma. The therapeutic efficacy of immune checkpoint inhibitors for head and neck mucosal melanoma remains unclear. Surgery is considered as the mainstay of treatment for locally advanced head and neck mucosal melanoma, and adjuvant radiotherapy has a role in local disease control. New treatment modalities, such as targeted therapy and immunotherapy, have changed the treatment of cutaneous melanoma. However, patients with mucosal melanoma have been excluded from most Phase III clinical trials. Due to its rarity, outcome data for locally advanced head and neck mucosal melanoma are scarce and are mainly based on retrospective studies with limited case numbers. The objective of this review was to provide an update and overview of clinical trials, prospective observational studies and retrospective studies and discuss future directions for multimodal treatment of locally advanced head and neck mucosal melanoma.
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Affiliation(s)
- Motoo Nomura
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
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22
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Montenegro C, Mattavelli D, Lancini D, Paderno A, Marazzi E, Rampinelli V, Tomasoni M, Piazza C. Treatment and outcomes of minor salivary gland cancers of the larynx and trachea: a systematic review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2023; 43:365-374. [PMID: 37814980 PMCID: PMC10773543 DOI: 10.14639/0392-100x-n2635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/10/2023] [Indexed: 10/11/2023]
Abstract
Objectives Malignant minor salivary glands carcinomas (MiSGC) of the larynx and trachea are rare tumours and published evidence is sparse. We conducted a systematic review to describe shareable treatment strategies and oncological outcomes of these neoplastic entities. Methods Full text English manuscripts published from January 1st 2000 to December 14th 2022 were included. Data on demographics, treatments and outcomes were collected. A pooled analysis of 5-year overall survival (OS) was performed. Results Seventeen articles and 365 patients met the inclusion criteria. The most common subsites involved were subglottic and distal trachea. Adenoid cystic carcinoma was, by far, the most frequent histotype. The first-choice treatment strategy was surgery (86.8%), while adjuvant treatments were delivered in 57.4% of patients. Only 12.9% were treated with definitive radiotherapy with/without chemotherapy. The mean follow-up was 68.3 months. One hundred nine (34.9%) deaths were recorded and 62.4% were cancer-related. Five-year OS ranged from 20% to 100% and, at pooled analysis, it was 83% (range, 78-87%). Conclusions In case of MiSGC of the larynx and trachea, surgery remains the mainstay of treatment. Adjuvant treatments are frequently delivered. Survival estimates are good overall, but highly heterogeneous.
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Affiliation(s)
- Claudia Montenegro
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Davide Lancini
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Alberto Paderno
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Elisa Marazzi
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Cesare Piazza
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
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23
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Robbins KT, Ronen O, Saba NF, Strojan P, Vander Poorten V, Mäkitie A, López F, Rodrigo JP, Homma A, Hanna E, Ferlito A. Progress and emerging strategies to preserve function in the treatment of sinonasal cancer. Head Neck 2023; 45:2955-2966. [PMID: 37740399 DOI: 10.1002/hed.27510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/27/2023] [Accepted: 08/27/2023] [Indexed: 09/24/2023] Open
Abstract
The sinonasal structures and their adjacent organs host several functions including vision, olfaction, nasal respiration and filtration, secretory immunity, facial expression, articulation, and oral deglutition. We reviewed the current evidence supporting functional preservation in sinonasal cancer treatment. Primary surgery with or without adjuvant modalities continues to be the standard of care for sinonasal cancer. Unfortunately, functional compromise remains a dominant negative feature of this approach. More recently, through advances in therapeutic techniques and improved understanding of the relevant tumor biology, treatments aimed at preserving function and cosmesis are emerging. The evidence for such progress involving minimal access surgery, surgical reconstruction for rehabilitation, new techniques in radiation therapy, inclusion of systemic and locally enhanced chemotherapy, and therapeutic agents based on molecular targets are highlighted. This multi-prong approach bodes well for future patients with sinonasal cancer to undergo successful treatment that includes maximal preservation of associated functions.
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Affiliation(s)
- Kevin T Robbins
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Southern Illinois University, Springfield, Illinois, USA
| | - Ohad Ronen
- Department of Otolaryngology - Head and Neck Surgery, Galilee Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Primoz Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Vincent Vander Poorten
- Otorhinolaryngology - Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Section of Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Antti Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain
| | - Akihiro Homma
- Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Ehab Hanna
- Department of Head & Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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24
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Codina-Martínez H, Lorenzo-Guerra SL, Cabal VN, García-Marín R, Suárez-Fernández L, Vivanco B, Sánchez-Fernández P, López F, Llorente JL, Hermsen MA. Signaling Pathways mTOR and ERK as Therapeutic Targets in Sinonasal Intestinal-Type Adenocarcinoma. Int J Mol Sci 2023; 24:15110. [PMID: 37894790 PMCID: PMC10606341 DOI: 10.3390/ijms242015110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
Despite advances in surgery and radiotherapy, the overall prognosis of sinonasal intestinal-type adenocarcinoma (ITAC) is poor, and new treatment options are needed. Recent studies have indicated alterations in cellular signaling pathways that may serve as targets for modern inhibitors. Our aim was to evaluate the frequency of mTOR and ERK pathway upregulation in a retrospective series of 139 ITAC and to test the efficacy and mechanism of action of candidate targeted inhibitors in cell line ITAC-3. An immunohistochemical analysis on p-AKT, p-mTOR, p-S6, p-4E-BP1, and p-ERK indicated, respectively, a 68% and 57% mTOR and ERK pathway activation. In vitro studies using low doses of mTOR inhibitor everolimus and ERK inhibitor selumetinib showed significant growth inhibition as monotherapy and especially as combined therapy. This effect was accompanied by the downregulation of mTOR and ERK protein expression. Our data open a new and promising possibility for personalized treatment of ITAC patients.
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Affiliation(s)
- Helena Codina-Martínez
- Department of Head and Neck Cancer, Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain; (H.C.-M.); (S.L.L.-G.); (V.N.C.); (R.G.-M.); (L.S.-F.)
| | - Sara Lucila Lorenzo-Guerra
- Department of Head and Neck Cancer, Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain; (H.C.-M.); (S.L.L.-G.); (V.N.C.); (R.G.-M.); (L.S.-F.)
| | - Virginia N. Cabal
- Department of Head and Neck Cancer, Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain; (H.C.-M.); (S.L.L.-G.); (V.N.C.); (R.G.-M.); (L.S.-F.)
| | - Rocío García-Marín
- Department of Head and Neck Cancer, Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain; (H.C.-M.); (S.L.L.-G.); (V.N.C.); (R.G.-M.); (L.S.-F.)
| | - Laura Suárez-Fernández
- Department of Head and Neck Cancer, Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain; (H.C.-M.); (S.L.L.-G.); (V.N.C.); (R.G.-M.); (L.S.-F.)
| | - Blanca Vivanco
- Department of Pathology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain;
| | - Paula Sánchez-Fernández
- Department of Otolaryngology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (P.S.-F.); (F.L.); (J.L.L.)
| | - Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (P.S.-F.); (F.L.); (J.L.L.)
| | - José Luis Llorente
- Department of Otolaryngology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (P.S.-F.); (F.L.); (J.L.L.)
| | - Mario A. Hermsen
- Department of Head and Neck Cancer, Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain; (H.C.-M.); (S.L.L.-G.); (V.N.C.); (R.G.-M.); (L.S.-F.)
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25
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Wang Z, Zhang J, Yang B, Zhang Y, Chen X, Wang J, Wu R, Wang K, Qu Y, Huang X, Luo J, Gao L, Xu G, Li YX, Yi J. T4b Sinonasal Squamous Cell Carcinoma: Surgery Plus Radiotherapy May Contribute to Prolonged Survival. Laryngoscope 2023; 133:2222-2231. [PMID: 36583385 DOI: 10.1002/lary.30545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/22/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE To determine oncologic outcomes for patients with T4b sinonasal squamous cell carcinoma (SNSCC) treated with either surgery plus radiotherapy or definitive radiotherapy. MATERIALS AND METHODS Between January 1999 and December 2016, 85 patients with T4b SNSCC were analyzed retrospectively, there were 54 who received surgery plus radiotherapy (S + RT group) ± chemotherapy and 31 with definitive radiotherapy (RT group) ± chemotherapy. A 1: 2 propensity score matching (PSM) was performed to balance clinical factors and match patients. Kaplan-Meier method and Cox proportional hazard model were used to determine risk factors on survival outcomes. RESULTS The median follow-up time was 76.7 months. The cumulative rates of locoregional control (LRC), distant metastasis-free survival (DMFS), cancer-specific survival (CSS), and overall survival (OS) at 5 years for entire cohort were 44.6%, 33.1%, 38.8%, and 33.9% respectively. After PSM, a total of 50 patients in S + RT group and 25 patients in RT group were analyzed. The 5-year LRC, DMFS, CSS, and OS between S + RT and RT group were 58.6% versus 27.5% (p = 0.035), 42.8% versus 20.0% (p = 0.006), 50.3% versus 22.0% (p = 0.005), 44.5% veruss 20.0% (p = 0.004). The 5-year survival rates with orbital retention between groups were 32.7% and 15.0%, p = 0.080. Multivariate Cox analysis revealed non-surgical therapy (HR = 3.678, 95%CI 1.951-6.933) and invasion of cranial nerves (other than maxillary division of trigeminal nerves) (HR = 2.596, 95%CI 1.217-5.535) were associated with decreased OS. CONCLUSION The inclusion of surgery in the multimodal management of T4b SNSCC might confer a survival benefit. Further prospective studies comparing the oncologic outcomes of S + RT with RT are warranted. LEVEL OF EVIDENCE 3 Laryngoscope, 133:2222-2231, 2023.
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Affiliation(s)
- Zekun Wang
- 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
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bining Yang
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Gao
- 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
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye-Xiong Li
- 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
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Cancer Center/National Clinical Research Center for Cancer/Hebei Cancer Hospital, Chinese Academy of Medical Sciences, Langfang, China
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26
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Sileo G, Valentini M, Gravante G, Monti G, Arosio AD, Bignami M, Battaglia P, Castelnuovo P, Turri-Zanoni M. Sinonasal Malignancies Involving the Frontal Sinus: A Mono-Institutional Experience of 84 Cases and Systematic Literature Review. J Clin Med 2023; 12:jcm12093186. [PMID: 37176626 PMCID: PMC10179019 DOI: 10.3390/jcm12093186] [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: 02/23/2023] [Revised: 04/22/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Frontal sinus involvement by malignant tumors is a rare finding. Therefore, a systematic literature review along with a personal case series may contribute to defining more accurately the epidemiology, treatment options, and outcomes of these neoplasms. This is a retrospective review of patients affected by frontal sinus malignancies surgically treated in a tertiary-care referral center over a period of 20 years. Moreover, a systematic literature review of studies describing frontal sinus cancers from 2000 to date was performed according to PRISMA guidelines in order to analyze current evidence about the treatment and outcomes of such a rare disease. Our retrospective review was basedon 84 cases, treated with an exclusive endoscopic approach in 43 cases (51.2%), endoscopic approach with frontal osteoplastic flap in 6 cases (7.1%), and transfacial or transcranial approaches in 35 cases (41.7%). The five-year overall, disease-specific, disease-free, and recurrence-free survivals were 54.6%, 62.6%, 33.1%, and 59.1%, respectively. Age, dural involvement, type of surgical resection, and surgical margin status were significantly associated with the survival endpoints. In conclusion, the involvement of the frontal sinus is associated with a poor prognosis. Multidisciplinary management, including specific histology-driven treatments, represents the gold standard for improving outcomes and minimizing morbidity.
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Affiliation(s)
- Giorgio Sileo
- Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, University of Insubria, 21100 Varese, Italy
| | - Marco Valentini
- Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, University of Insubria, 21100 Varese, Italy
| | - Giacomo Gravante
- Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, University of Insubria, 21100 Varese, Italy
| | - Giulia Monti
- Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, University of Insubria, 21100 Varese, Italy
| | - Alberto D Arosio
- Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, University of Insubria, 21100 Varese, Italy
| | - Maurizio Bignami
- Department of Otolaryngology Head and Neck Surgery, ASST Lariana, Ospedale Sant'Anna, University of Insubria, 22042 Como, Italy
- Head and Neck Surgery and Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
| | - Paolo Battaglia
- Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, University of Insubria, 21100 Varese, Italy
- Head and Neck Surgery and Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
| | - Paolo Castelnuovo
- Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, University of Insubria, 21100 Varese, Italy
- Head and Neck Surgery and Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
| | - Mario Turri-Zanoni
- Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, University of Insubria, 21100 Varese, Italy
- Head and Neck Surgery and Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
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27
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Ferrari M, Alessandrini L, Savietto E, Cazzador D, Schiavo G, Taboni S, Carobbio ALC, Calvanese L, Contro G, Gaudioso P, Emanuelli E, Sbaraglia M, Zanoletti E, Marioni G, Dei Tos AP, Nicolai P. The Prognostic Role of the Immune Microenvironment in Sinonasal Intestinal-Type Adenocarcinoma: A Computer-Assisted Image Analysis of CD3 + and CD8 + Tumor-Infiltrating Lymphocytes. J Pers Med 2023; 13:jpm13050726. [PMID: 37240896 DOI: 10.3390/jpm13050726] [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: 03/21/2023] [Revised: 04/14/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
The prognostic value of conventional histopathological parameters in the sinonasal intestinal-type adenocarcinoma (ITAC) has been debated and novel variables should be investigated. Increasing evidence demonstrated that the evolution of cancer is strongly dependent upon the complex interactions within tumor microenvironment. The aim of this retrospective study was to assess the features of immune microenvironment in terms of CD3+ and CD8+ cells in a series of ITAC and explore their prognostic role, as well as their relations with clinicopathological variables. A computer-assisted image analysis of CD3+ and CD8+ tumor-infiltrating lymphocytes (TIL) density was conducted on surgical specimens of 51 patients with ITAC that underwent a curative treatment including surgery. ITAC displays variable TIL density, which is associated with OS. In a univariate model, the density of CD3+ TIL was significantly related to OS (p = 0.012), whereas the association with CD8+ TIL density resulted in being non-significant (p = 0.056). Patients with intermediate CD3+ TIL density were associated with the best outcome, whereas 5-year OS was the lowest for intermediate CD8+ TIL density. CD3+ TIL density maintained a significant association with OS in the multivariable analysis. TIL density was not significantly related to demographic and clinicopathological variables. CD3+ TIL density was independently associated with OS in a non-linear fashion and patients with intermediate CD3+ TIL density had the best outcome. Though based on a preliminary analysis on a relatively small series of patients, this finding makes TIL density a potential independent prognostic factor of ITAC.
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Affiliation(s)
- Marco Ferrari
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
- Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, ON M5G1L7, Canada
- Technology for Health (PhD Program), Department of Information Engineering, University of Brescia, 25123 Brescia, Italy
| | - Lara Alessandrini
- Section of Pathology, Department of Medicine, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Enrico Savietto
- Unit of Otolaryngology, Hospital of Treviso AULSS 2-Marca Trevigiana, 31100 Treviso, Italy
| | - Diego Cazzador
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Gloria Schiavo
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Stefano Taboni
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
- Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, ON M5G1L7, Canada
- Artificial Intelligence in Medicine and Innovation in Clinical Research and Methodology, Department of Clinical and Experimental Sciences, University of Brescia, 25100 Brescia, Italy
| | - Andrea L C Carobbio
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Leonardo Calvanese
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Giacomo Contro
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
- Technology for Health (PhD Program), Department of Information Engineering, University of Brescia, 25123 Brescia, Italy
| | - Piergiorgio Gaudioso
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Enzo Emanuelli
- Unit of Otolaryngology, Hospital of Treviso AULSS 2-Marca Trevigiana, 31100 Treviso, Italy
| | - Marta Sbaraglia
- Section of Pathology, Department of Medicine, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Gino Marioni
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Angelo P Dei Tos
- Section of Pathology, Department of Medicine, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
| | - Piero Nicolai
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, 35128 Padua, Italy
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Hermsen MA, Bossi P, Franchi A, Lechner M. Sinonasal Cancer: Improving Classification, Stratification and Therapeutic Options. Cancers (Basel) 2023; 15:1675. [PMID: 36980561 PMCID: PMC10046049 DOI: 10.3390/cancers15061675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
The nasal cavities and paranasal sinuses are the site of origin of a wide spectrum of histologically and clinically distinct disease entities [...].
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Affiliation(s)
- Mario A. Hermsen
- Department Head and Neck Oncology, Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain
| | - Paolo Bossi
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Alessandro Franchi
- Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Matt Lechner
- UCL Cancer Institute, University College London, London WC1E 6BT, UK
- Division of Surgery and Interventional Science, Academic Head and Neck Centre University College London, London WC1E 6BT, UK
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Carsuzaa F, Favier V, Ferrari M, Turri-Zanoni M, Ingargiola R, Camarda AM, Seguin L, Contro G, Orlandi E, Thariat J. Need for close interdisciplinary communication after endoscopic endonasal surgery to further personalize postoperative radiotherapy in sinonasal malignancies. Front Oncol 2023; 13:1130040. [PMID: 36925924 PMCID: PMC10012420 DOI: 10.3389/fonc.2023.1130040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Affiliation(s)
- Florent Carsuzaa
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Poitiers, Poitiers, France
| | - Valentin Favier
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| | - Marco Ferrari
- Section of Otorhinolaryngology - Head and Neck Surgery, University of Padova, "Azienda Ospedale Università di Padova", Padova, Italy
| | - Mario Turri-Zanoni
- Division of Otorhinolaryngology - Head and neck surgery, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi University Hospital, Varese, Italy
| | - Rossana Ingargiola
- Radiation Oncology, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Anna Maria Camarda
- Radiation Oncology, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Lise Seguin
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Poitiers, Poitiers, France
| | - Giacomo Contro
- Section of Otorhinolaryngology - Head and Neck Surgery, University of Padova, "Azienda Ospedale Università di Padova", Padova, Italy
| | - Ester Orlandi
- Radiation Oncology, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Juliette Thariat
- Radiation Oncology, Centre François Baclesse: ARCHADE, Caen, France
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Arosio AD, Bernasconi DP, Valsecchi MG, Pacifico C, Battaglia P, Bignami M, Ferrari M, Mattavelli D, Rampinelli V, Tomasoni M, Schreiber A, Gualtieri T, Piazza C, Magrini SM, Tartaro T, Molteni M, Lambertoni A, Sileo G, Bossi P, Orlandi E, Bertazzoni G, Fiaux-Camous D, Jourdaine C, Verillaud B, Herman P, Nicolai P, Castelnuovo P, Turri-Zanoni M. Patterns of recurrences in sinonasal cancers undergoing an endoscopic surgery-based treatment: Results of the MUSES* on 940 patients: *MUlti-institutional collaborative Study on Endoscopically treated Sinonasal cancers. Oral Oncol 2022; 134:106123. [PMID: 36174456 DOI: 10.1016/j.oraloncology.2022.106123] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/18/2022] [Accepted: 09/04/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The improvements in survival with expansion of the survivors' population, along with evolution of endoscopically-based treatment modalities, have contributed to emphasize the clinical relevance of recurrences in sinonasal cancers. However, at present, literature is scant regarding the pattern of recurrences and the therapeutic strategies available to manage long survivors who experienced single or multiple failures. The aim of the present study was to analyze sinonasal cancers recurrences to provide data regarding rates and patterns of relapse, predictors of failure and prognostic impact of the recurrence. MATERIALS AND METHODS All patients receiving multimodal treatments including endoscopic surgery between 1995 and 2021 in three European referral centers were included. Statistical analysis of survival was performed through univariable, multivariable and unidirectional multistate models. Survival after recurrence analysis was implemented for patients experiencing at least one recurrence. RESULTS The 5- and 10-year recurrence free survival rates were 34.1% and 38.4% for the whole population. With a mean follow-up time of 60 months, a global recurrence rate of 32.9% was observed. The 5- and 10-year survival after recurrence rates were 27.2% and 21.7%, respectively. Incidence and rates of recurrences were significantly associated with histology subtypes. CONCLUSION This study provides valuable oncologic outcomes regarding a large homogenous cohort of patients affected by sinonasal malignances treated within a multimodal framework, emphasizing the strong correlation of histologic type with prognosis, as well as with pattern of recurrences.
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Affiliation(s)
- Alberto Daniele Arosio
- Division of Otorhinolaryngology, Department of Surgical Specialties, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", Varese, Italy.
| | - Davide Paolo Bernasconi
- Bicocca Bioinformatics Biostatistics and Bioimaging Centre - B4, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Maria Grazia Valsecchi
- Bicocca Bioinformatics Biostatistics and Bioimaging Centre - B4, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Claudia Pacifico
- Bicocca Bioinformatics Biostatistics and Bioimaging Centre - B4, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Paolo Battaglia
- Division of Otorhinolaryngology, Department of Surgical Specialties, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", Varese, Italy; Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", University of Insubria, Varese, Italy; Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Maurizio Bignami
- Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy; Division of Otorhinolaryngology, "ASST Lariana", University of Insubria, Como, Italy
| | - Marco Ferrari
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, Padua, Italy; Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, ON, Canada; Technology for Health (Program), Department of Information Engineering, University of Brescia, Brescia, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Vittorio Rampinelli
- Technology for Health (Program), Department of Information Engineering, University of Brescia, Brescia, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Alberto Schreiber
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Tommaso Gualtieri
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Cesare Piazza
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Stefano Maria Magrini
- Unit of Radiation Oncology, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Tiziana Tartaro
- Department of Medical Oncology, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", Varese, Italy
| | - Marinella Molteni
- Department of Radiotherapy, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", Varese, Italy
| | - Alessia Lambertoni
- Division of Otorhinolaryngology, Department of Surgical Specialties, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", Varese, Italy
| | - Giorgio Sileo
- Division of Otorhinolaryngology, Department of Surgical Specialties, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", Varese, Italy
| | - Paolo Bossi
- Unit of Medical Oncology, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, "ASST Spedali Civili di Brescia", University of Brescia, Brescia, Italy
| | - Ester Orlandi
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | | | | | - Clement Jourdaine
- Department of Otorhinolaryngology, Lariboisière University Hospital, Paris, France
| | - Benjamin Verillaud
- Department of Otorhinolaryngology, Lariboisière University Hospital, Paris, France
| | - Philippe Herman
- Department of Otorhinolaryngology, Lariboisière University Hospital, Paris, France
| | - Piero Nicolai
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, "Azienda Ospedale Università di Padova", University of Padua, Padua, Italy
| | - Paolo Castelnuovo
- Division of Otorhinolaryngology, Department of Surgical Specialties, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", Varese, Italy; Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", University of Insubria, Varese, Italy; Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Mario Turri-Zanoni
- Division of Otorhinolaryngology, Department of Surgical Specialties, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", Varese, Italy; Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, "ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi", University of Insubria, Varese, Italy; Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
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Chen MY, Wen X, Wei Y, Chen L, Huang ZX, Lu T, Zheng NZ, Li J, Wen WP, Wen YH. Oncologic outcome of multimodality treatment for sinonasal malignancies: An 18-year experience. Front Oncol 2022; 12:958142. [PMID: 36132140 PMCID: PMC9484525 DOI: 10.3389/fonc.2022.958142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/03/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The aim of this study was to retrospectively evaluate the oncologic outcomes of sinonasal malignancies (SNMs) of various histologic subtypes and investigate the impact of multimodality treatment on prognosis of SNM. Methods SNM patients treated with curative-intent surgery from 2000 to 2018 were included. The primary outcomes were overall survival (OS). Survival was then assessed through Cox proportional hazards models. Results Three hundred and three patients were eligible for the analysis. The 5-year OS and event-free survival (EFS) were 61.0% (95% CI: 55.4%–67.1%) and 46.2% (95% CI: 40.4%–52.7%). The 5-year OS was the worst for malignant melanoma and the best for adenocarcinoma. Patients who received surgery had better OS than those who only received radiotherapy and/or chemotherapy. Endoscopic surgery had better OS than the open approach (p < 0.05). Microscopically margin-negative resection (R0 resection) significantly benefited OS and EFS (p < 0.001). No significant difference in OS was observed between patients who received macroscopic complete resection (R1 resection) followed by adjuvant therapy and patients who received R0 resection. Older age (HR = 1.02, p = 0.02), R1 resection (HR = 1.99, p = 0.02), sinonasal surgical history of more than 3 months before diagnosis (HR = 2.77, p = 0.007), and radiotherapy history (HR = 3, p = 0.006) are risk factors for worse EFS. Conclusions Curative-intent surgery is irreplaceable in the treatment of SNM. The endoscopic approach is an effective alternative to the open approach. EFS is worse among patients with older age, R1 resection, sinonasal surgical history of more than 3 months before diagnosis, and radiotherapy history.
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Affiliation(s)
- Meng-Yu Chen
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, China
| | - Xin Wen
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, China
| | - Yi Wei
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, China
| | - Lin Chen
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, China
| | - Zi-Xuan Huang
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, China
| | - Tong Lu
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, China
| | - Nian-Zhen Zheng
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, China
| | - Jian Li
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, China
| | - Wei-Ping Wen
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, China
- Department of Otolaryngology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Yi-Hui Wen, ; Wei-Ping Wen,
| | - Yi-Hui Wen
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Yi-Hui Wen, ; Wei-Ping Wen,
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