Endoscopic resection of sinonasal malignancies

Abdelmeguid, Ahmed S.; Raza, Shaan M.; Su, Shirley Y.; Kupferman, Michael E.; Roberts, Dianna B.; DeMonte, Franco; Hanna, Ehab Y.

doi:10.1002/hed.26047

Cited by 43 publications

(65 citation statements)

References 25 publications

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“…The incidence of complications after CFR was about 30-60%, and the mortality rate was 0-13% (35). However, the overall complication rate after endoscopic surgery of anterior skull base tumors or sinonasal malignancies was significantly reduced, about 3-29%, and the mortality rate was 0-1% (36,37). Endoscopic surgery may be divided into categories: cranioendoscopic approach (CEA), exclusively endoscopic approach (EEA).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Survival Outcomes and Treatment Experience of 64 Patients With Esthesioneuroblastoma

Zeng

Tian

et al. 2021

Front. Oncol.

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Background: Esthesioneuroblastoma (ENB) is a rare sinonasal malignancy, lacking a unified staging system and treatment. Management at a single center was retrospectively evaluated to inform future treatment options and prognostic factors.Methods: Clinical data of 64 consecutive ENB patients, including prognostic factors and treatment methods, were reviewed retrospectively. Data were collected to calculate overall survival (OS) and progression free survival (PFS).Results: The majority of tumors 84.4% were within Kadish C stage, 79.7% were within T3 or T4, and 64.0% were within Hyams grade III or IV. A total of 50 (78.1%) patients received surgery and combined radiotherapy with or without chemotherapy, 10 (15.6%) received surgery with or without chemotherapy alone, and 4 (6.3%) received radiotherapy with or without chemotherapy alone. The majority of patients (79.7%) underwent endoscopic resection (endoscopic and endoscopically assisted). Surgery combined with radiotherapy with or without chemotherapy resulted in significantly better OS (84.4 vs. 50.6%, 84.4 vs. 37.5%) compared to surgery alone and radiotherapy alone (P = 0.0064). Endoscopic surgery group (endoscopic and endoscopically assisted) resulted in significantly better 5-year PFS (61.7 vs. 22.2%) compared to the open surgery group (P < 0.001). Although endoscopic surgery group was not a statistically significant predictor of 5-year OS (P = 0.54), the 5-year OS was 79.3% for the endoscopic surgery group and 76.2% for the open surgery group. A Cox regression analysis identified intracranial extension and surgery combined with radiotherapy as independent factors affecting 5-year OS while cervical lymph node metastasis and Hyams grade IV as independent factors affecting 5-year PFS.Conclusion: Our findings suggest that surgery combined with radiotherapy is the best treatment approach for ENB. For advanced tumors, endoscopic surgery is an effective treatment, and its survival rate is equal to or better than open surgery.

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Section: Discussionmentioning

confidence: 99%

Long-Term Survival Outcomes and Treatment Experience of 64 Patients With Esthesioneuroblastoma

Zeng

Tian

et al. 2021

Front. Oncol.

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“…Endoscopic surgery is an approach that has greatly evolved over the last few decades, and it has been associated with good oncological results in some series (16). However, some criteria have been described as relative contraindications to the endoscopic approach, including involvement of the nasal bones, lateral frontal sinuses, lacrimal system, orbit, anterior maxillary sinuses, dura mater, cavernous sinus, and brain parenchyma (17), all of which were frequently documented in the present series.…”

Section: ' Discussionmentioning

confidence: 60%

Short-term survival in extensive craniofacial resections

Leite

Alvarenga

Gonçalves

et al. 2021

Clinics

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Craniofacial resection (CFR) procedures for craniofacial tumors with cranial extension are often extensive. Although CFRs may yield good oncological results, there are concerns about high perioperative morbidity and mortality. This study aimed to determine risk factors for perioperative mortality after open CFR in terms of deaths occurring during index hospitalizations. METHODS: We conducted a retrospective analysis of CFRs conducted at a tertiary oncology hospital from May 2009 through December 2018. RESULTS: Our analysis included data from the medical records of 102 patients, the majority of whom were male (n=74, 72.5%). The mean age was 61 years ( ± 18.3 years). Skin malignancies (n=64, 63.4%) accounted for nearly two-thirds of the treated tumors, and most of these were squamous cell carcinoma. Postoperative medical complications occurred in 33 patients (33%), and surgical complications occurred in 48 (47%). Multivariate analysis revealed the only independent risk factors for perioperative deaths to be the presence of intracranial tumor extension on preoperative imaging (hazard ratio [HR]=4.56; 95% confidence interval [CI]: 1.74-11.97; p=0.002) and the unexpected emergence of postoperative neurological dysfunction (HR=10.9; 95% CI: 2.21-54.3; p=0.003). CONCLUSIONS: In our study, factors related to tumor extension were associated with a higher risk of perioperative death.

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“…A followup study of 239 patients, 167 (70%) of which had a purely endoscopic resection, revealsed no difference in surgical margin status between the pure endoscopic and endoscopicassisted groups. There was no significant difference in survival between these groups [35]. These data in our minds are a proof of principle that in appropriately selected patients a purely endoscopic approach to tumoral resection could be safely performed without compromising patient survival.…”

Section: Oncologicmentioning

confidence: 56%