Three‐dimensional endoscopy for endoscopic salvage nasopharyngectomy: Preliminary report of experience

Chan, Jimmy Yu Wai; Wei, William Ignace

doi:10.1002/lary.26993

Cited by 23 publications

(19 citation statements)

References 19 publications

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“…In comparison with the 2D HD laryngoscopy, most 3D recordings were self‐explanatory in making the diagnosis of laryngotracheal findings safer due to more realistic depth and spatial visualization. These results are in line with the evaluation of findings in other medical disciplines, which have longer histories of using 3D endoscopy, especially in skull base and laparoscopic surgery . However, Van Gompel et al demonstrated a loss of field of view when using 0 ° 3D rigid endoscopes compared to 2D endoscopy.…”

Section: Discussionsupporting

confidence: 80%

Development of three‐dimensional laryngostroboscopy for office‐based laryngeal diagnostics and phonosurgical therapy

et al. 2018

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Objective To develop a three‐dimensional (3D) laryngostroboscopic examination unit, compare the optic playback quality in relation to established 2D procedures, and report the first case series using 3D rigid laryngostroboscopy for diagnosis and management of laryngotracheal diseases. Study Design Laboratory study, prospective case series. Methods The optical efficacy of newly developed rigid 3D endoscopes was examined in a laboratory setting. Diagnostic suitability was investigated in 100 subjects (50 male, 50 female) receiving 2D high‐definition (HD) and 3D laryngostroboscopy. Two of the subjects subsequently underwent 3D‐assisted office‐based transoral phonosurgery under local anesthesia. Main outcome measures were comparative visualization of laryngotracheal pathologies, influence on preoperative planning, and evaluation of prognostic factors for the outcome of phonosurgical interventions. Results Three‐dimensional endostroboscopic procedures were effectively optimized to establish an examination protocol for all‐day clinical use. Office‐based 3D laryngostroboscopy was successfully applied in subjects with normal anatomy (n = 10) and various laryngotracheal findings (n = 90). In comparison to 2D HD videolaryngostroboscopy, the 3D view offered enhanced visualization of laryngotracheal anatomy, with qualitatively improved depth perception and spatial representation. In organic pathologies, this resulted in a more precise indication of phonosurgical procedures, increased accuracy in surgical planning, facilitated office‐based endoscopic surgery, and better evaluation of prognostic factors for the outcome of phonosurgical interventions. Conclusion Three‐dimensional laryngostroboscopy proved to increase the understanding of functional and surgical anatomy. Its application has enormous potential for improving the diagnostic value of laryngoscopy, surgical precision in laryngotracheal interventions, tissue preservation, and methods of teaching. Level of Evidence NA Laryngoscope, 128:2823–2831, 2018

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Section: Discussionsupporting

confidence: 80%

Development of three‐dimensional laryngostroboscopy for office‐based laryngeal diagnostics and phonosurgical therapy

et al. 2018

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“…This technique, in recent years, has made great strides in disease-specific survival rates (equating those of open techniques). 8 Salvage neck dissection may be an alternative intervention if RT is contraindicated. 6 In Stage IVB disease (formerly IVC under 7th AJCC staging), NPC has metastasized to distant sites either at presentation or post initial curative treatment.…”

Section: Current Treatmentsmentioning

confidence: 99%

“…Some tumours that persist or recur in the nasopharynx can be removed via endoscopic skull base surgery. This technique, in recent years, has made great strides in disease‐specific survival rates (equating those of open techniques) . Salvage neck dissection may be an alternative intervention if RT is contra‐indicated …”

Section: Introductionmentioning

confidence: 99%

Immune checkpoint inhibitors in advanced nasopharyngeal carcinoma: Beyond an era of chemoradiation?

Masterson

Howard

Gonzalez-Cruz

et al. 2020

Intl Journal of Cancer

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Now is an exciting era of development in immunotherapy checkpoint inhibitors and their effect on the treatment of NPC. While the general prognosis of R/M disease is poor, immunotherapy offers some promise in a malignancy associated with EBV and characterized by a peritumoural immune infiltrate. Our study aims to review past and on‐going clinical trials of monoclonal antibody therapies against the checkpoint inhibitors (e.g. PD1 and CTLA‐4), in R/M NPC. All randomized and nonrandomized controlled trials involving immune checkpoint inhibitor interventions for treatment of NPC were included in the study. We utilized a validated “risk of bias” tool to assess study quality. Four separate Phase I–II trials report the potential of PD1 inhibitor treatment for patients with NPC. Within the observed groups, camrelizumab combined with chemotherapy achieved an objective response in 91% of patients as first‐line treatment for metastatic NPC (PFS 68% at 1‐year) but this was associated with a high rate of grade >3 adverse events (87%; CTCAE version 4.03). The remaining three studies focused on recurrent NPC disease in patients who had received at least one line of prior chemotherapy. Within this group, camrelizumab monotherapy achieved an objective response in 34% of patients (PFS 27% at 1‐year; range across all three studies 20.5–34%). No NPC trial has yet reported on specific outcomes for non‐PD1 checkpoint inhibitors but 11 on‐going studies include alternative targets (e.g. PD‐L1/CTLA‐4) as combination or monotherapy treatments. In considering checkpoint immunotherapies for NPC, initial results show promise for anti‐PD1 interventions. Further phase I–III trials are in progress to clarify clinical outcomes, fully determine safety profiles, and optimize drug combinations and administration schedules.

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“…Some recent studies showed that 125 I brachytherapy was a feasible, safe, and effective treatment for locally recurrent NPC, and the 3D high‐definition endoscopic system improves the precision of endoscopic nasopharyngectomy, particularly when dissection of the internal carotid artery and dura is required . With advances in technology, the appropriate treatment protocol for patients with detected pre EBV DNA may need further study.…”

Section: Discussionmentioning

confidence: 99%

“…Some recent studies showed that 125 I brachytherapy was a feasible, safe, and effective treatment for locally recurrent NPC, 41 and the 3D high-definition endoscopic system improves the precision of endoscopic nasopharyngectomy, particularly when dissection of the internal carotid artery and dura is required. 42 With advances in technology, the appropriate treatment protocol for patients with detected pre EBV DNA may need further study. Additionally, the results of multivariate analysis showed that patients with undetected pre EBV DNA have an obviously better prognosis than patients with detected pre EBV DNA, and recurrent clinical stage is as ever the most significant prognostic factor for OS.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and prognostic value of pre‐retreatment plasma epstein‐barr virus DNA in locoregional recurrent nasopharyngeal carcinoma

et al. 2019

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Purpose To define the clinical characteristics and prognostic value of pre‐retreatment plasma Epstein‐Barr virus (EBV) DNA, we investigated EBV status in locoregional recurrent nasopharyngeal carcinoma (lrNPC) patients. Methods Between April 2008 and August 2016, the data of patients with nonmetastatic lrNPC were retrospectively reviewed. The survival indexes of patients between different pre‐retreatment EBV status groups were compared. Results A total of 401 patients with nonmetastatic lrNPC were enrolled, and 197 (49.1%) patients had detectable pre‐retreatment plasma EBV DNA. Treatment included radiotherapy alone (n = 37 patients), surgery alone (n = 105), radiotherapy (n = 208), surgery combined with radiotherapy (n = 20), chemotherapy and targeted therapy (n = 31). Median follow‐up was 32 months. The 3‐year locoregional relapse‐free survival (LRRFS), distant metastasis‐free survival (DMFS), and overall survival (OS) rates for the entire cohort were 64.8%, 89.4%, and 58.8%, respectively. The estimated 3‐year LRRFS, DMFS, and OS rates for the pre EBV‐positive group vs the pre EBV‐negative group were 54.2% vs 75.0% ( P < 0.001), 86.6% vs 91.9% ( P = 0.05), 51.6% vs 65.9% ( P = 0.01), respectively. Among patients in the clinical stage rI/II, there were 17 patients in the radiotherapy alone group and 49 patients in the surgery alone group. And there was no significant difference in overall survival between radiotherapy and surgery, even among the different pre‐EBV statuses ( P > 0.05). In terms of long‐term toxic and side effects, the incidence of radioactive temporal lobe injury in the radiotherapy group was higher than that in the surgery group (35.3% vs 8.2%, P < 0.001), and no statistically significant difference was found in other long‐term toxic and side effects. Conclusions The positive rate of pre‐retreatment plasma EBV DNA in lrNPC is lower than primary NPC. The prognosis of EBV DNA negative group is better than positive group. For locally early‐stage lrNPC, regardless of EBV DNA status, radiotherapy and surgery are available options and both can achieve better long‐term survival.

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Three‐dimensional endoscopy for endoscopic salvage nasopharyngectomy: Preliminary report of experience

Abstract: 4. Laryngoscope, 128:1386-1391, 2018.

Cited by 23 publications

References 19 publications

Development of three‐dimensional laryngostroboscopy for office‐based laryngeal diagnostics and phonosurgical therapy

Development of three‐dimensional laryngostroboscopy for office‐based laryngeal diagnostics and phonosurgical therapy

Immune checkpoint inhibitors in advanced nasopharyngeal carcinoma: Beyond an era of chemoradiation?

Clinical characteristics and prognostic value of pre‐retreatment plasma epstein‐barr virus DNA in locoregional recurrent nasopharyngeal carcinoma

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