2.Neoadjuvant chemotherapy in the treatment of locally advanced olfactory neuroblastoma in 25 cases.
Yan SUN ; Shu Rong ZHANG ; Ming Jie WANG ; Qian HUANG ; Shun Jiu CUI ; Ben Tao YANG ; E QIU ; Cheng LI ; Bing ZHOU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(5):425-430
Objective: To evaluate the efficacy of neoadjuvant chemotherapy (NACT) in the treatment of locally advanced olfactory neuroblastoma (ONB), and to explore the factors related to the efficacy of NACT. Methods: A total of 25 patients with ONB who underwent NACT in Beijing TongRen Hospital from April 2017 to July 2022 were retrospectively analyzed. There were 16 males and 9 females, with an average age of 44.9 years (ranged 26-72 years). There were 22 cases of Kadish stage C and 3 cases of stage D. After multiple disciplinary team(MDT) discussion, all patients were treated sequentially with NACT-surgery-radiotherapy. Among them, 17 cases were treated with taxol, cis-platinum and etoposide (TEP), 4 cases with taxol, nedaplatin and ifosfamide (TPI), 3 cases with TP, while 1 case with EP. SPSS 25.0 software was used for statistical analysis, and survival analyses were calculated based on the Kaplan-Meier method. Results: The overall response rate of NACT was 32% (8/25). Subsequently, 21 patients underwent extended endoscopic surgery and 4 patients underwent combined cranial-nasal approach. Three patients with stage D disease underwent cervical lymph node dissection. All patients received postoperative radiotherapy. The mean follow-up time was 44.2 months (ranged 6-67 months). The 5-year overall survival rate was 100.0%, and the 5-year disease-free survival rates was 94.4%. Before NACT, Ki-67 index was 60% (50%, 90%), while Ki-67 index was 20% (3%, 30%) after chemotherapy [M (Q1, Q3)]. The change of Ki-67 before and after NACT was statistically significant (Z=-24.24, P<0.05). The effects of age, gender, history of surgery, Hyams grade, Ki-67 index and chemotherapy regimen to NACT were analyzed. Ki-67 index≥25% and high Hyams grade were related to the efficacy of NACT (all P<0.05). Conclusions: NACT could reduce Ki-67 index in ONBs. High Ki-67 index and Hyams grade are clinical indicators sensitive to the efficacy of NACT. NACT-surgery-radiotherapy is effective for patients with locally advanced ONB.
Male
;
Female
;
Humans
;
Adult
;
Middle Aged
;
Aged
;
Neoadjuvant Therapy/methods*
;
Retrospective Studies
;
Esthesioneuroblastoma, Olfactory/etiology*
;
Ki-67 Antigen
;
Paclitaxel
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*
;
Nasal Cavity
;
Nose Neoplasms/therapy*
;
Neoplasm Staging
5.The outcome of transnasal endoscopic total maxillectomy in the treatment of sinonasal adenoid cystic carcinoma.
Quan LIU ; Yuting LAI ; Jingyi YANG ; Huankang ZHANG ; Xicai SUN ; Yurong GU ; Houyong LI ; Hongmeng YU ; Dehui WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(4):243-251
Objective:To assess the prognosis of sinonasal adenoid cystic carcinoma with hard palatine invasion treated by transnasal endoscopic total maxillectomy. Methods:Clinical data of twenty-six patients with sinonasal adenoid cystic carcinoma invading hard palatine treated by transnasal endoscopic total maxillectomy between May 2014 and December 2020 was analyzed retrospectively. Survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Cox regression was used to investigate the prognosis factors. Masticatory function after maxillectomy has also been assessed using the questionnaire of patients' satisfaction about masticatory function. Results:Margins in 8 patients(30%) were positive. The median time of follow-up was 38 months(6 to 85 months). Twenty-five patients recurred. Four patients died of distant metastasis. The 5-year overall survival rate and relapse-free survival rate was 79.5% and 89.1%, respectively. Independent predictors of outcome on multivariate analysis were positive margin(P=0.018), recurrence(P=0.006) and distant metastasis(P=0.04). Conclusion:Transnasal endoscopic total maxillectomy could be performed for the treatment of the sinonasal adenoid cystic carcinoma with hard palatine invasion. Positive margin, local recurrence and distant metastasis were important predictors for patients' prognosis.
Humans
;
Carcinoma, Adenoid Cystic/pathology*
;
Paranasal Sinus Neoplasms/pathology*
;
Retrospective Studies
;
Neoplasm Recurrence, Local/pathology*
;
Prognosis
6.Clinical study of endoscopic surgery for recurrent nasopharyngeal carcinoma.
Yin HE ; Hai YIN ; Jiasen WU ; Wen ZHENG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(10):771-777
Objective:To compare the clinical effects and complications of surgery + chemotherapy and radiotherapy + chemotherapy in patients with nasopharyngeal carcinoma recurrence, so as to compare the safety and efficacy of two different therapeutic methods. Methods:A retrospective analysis was performed on 40 patients with recurrent nasopharyngeal carcinoma after radiotherapy and chemotherapy admitted to our hospital from January 2016 to June 2020. Among them, 26 patients were treated with surgery. The recurrent tumor was removed under nasal endoscope, and the frozen resection margin was negative during the operation. Chemotherapy was continued for stage Ⅲ and Ⅳ patients from 3 to 5 weeks after surgery. Fourteen patients received secondary radiotherapy and chemotherapy. Postoperative complications and survival rate were observed. Results:There were 14 patients in the secondary chemoradiotherapy group(control group) and 26 patients in the nasal endoscopic surgery group(observation group). Among the 26 patients, 19 patients underwent nasal septal mucosal repair, 5 patients underwent temporal muscle flap repair, 2 patients underwent submental flap repair, 2 patients had nasal septal mucosal flap necrosis and cerebrospinal fluid leakage, and the temporal muscle flap was used for secondary repair in the second stage operation, and 8 patients needed cervical lymph node dissection. The patients recovered well after surgery, and the patients in stage Ⅲ and Ⅳ were treated with chemotherapy after 3 weeks to 5 weeks according to the patient's wound condition. There were significant differences in the incidence of complications and 1-, 2-, and 3-year survival rates between the two groups(P<0.05). Conclusion:Patients with recurrent nasopharyngeal carcinoma can be treated by nasal endoscopic surgery to remove the tumor, and the use of pedicled nasal septal mucosal flap or temporal muscle flap for skull base reconstruction, The operation can effectively prevent major complications such as internal carotid artery rupture and hemorrhage, and improve the survival rate and quality of life of patients. It provides a safe and effective treatment for patients with recurrent nasopharyngeal carcinoma.
Humans
;
Plastic Surgery Procedures
;
Nasopharyngeal Carcinoma/surgery*
;
Retrospective Studies
;
Quality of Life
;
Skull Base/surgery*
;
Nose Diseases/pathology*
;
Nasopharyngeal Neoplasms/pathology*
7.Extranodal NK/T cell lymphoma, nasal type involving the larynx and digestive tract: a case report and literature review.
Sijie MA ; Xingjian CHEN ; Zengping LIU ; Yufen GUO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(11):920-923
Extranodal NK/T cell lymphoma, nasal type(ENKTL) is a highly aggressive malignant tumor derived from NK cells. This article reports a case of ENKTL invading the larynx and digestive tract. The clinical clinical manifestations include hoarseness and intranasal masses.
Humans
;
Lymphoma, Extranodal NK-T-Cell/pathology*
;
Nose/pathology*
;
Nose Neoplasms/pathology*
;
Larynx/pathology*
;
Gastrointestinal Tract/pathology*
9.Clinicopathological features of olfactory carcinoma.
C C ZHANG ; H LI ; L Q CHENG ; H B WU
Chinese Journal of Pathology 2023;52(11):1138-1143
Objective: To investigate the clinicopathological features and differential diagnosis of olfactory carcinoma (OC). Methods: Twenty-one cases of sinonasal tumors, including those initially diagnosed as olfactory neuroblastoma (ONB) and those with uncertain diagnosis, were collected from the Department of Pathology, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from January 2016 to August 2022, among which 3 cases were reclassified as OC. The clinicopathological features were investigated, and the remaining 18 cases were used as control. Results: Of the three OC patients, 2 were male and 1 was female, with an average age of 57 years ranging from 35 to 74 years. Microscopically, the tumor cells were arranged in solid, nested or lobulated patterns with occasional palisading around the solid nests. The stroma was highly vascular with focal neurofibrillary areas. There were prominent rosettes or pseudorosettes formation. The tumor cells were mainly ovoid to spindly with scant to moderate amount of cytoplasm, one or several small nucleoli, and fine chromatin content. Brisk mitotic figures were seen. In all 3 cases of OC, there were scanty atypical glands and some were ciliated. Immunohistochemically, at least one epithelial marker and neuroendocrine marker were diffusely expressed in the tumor. Some of the tumor cells were positive for p40 and p63, and the sustentacular cells showed the expression of S-100 protein. All cases tested were negative for NUT, CD99 and desmin, with intact expression of SMARCA4 (BRG1) and SMARCB1 (INI-1). Ki-67 proliferation index varied from 20% to 80%. Follow-up after 16-18 months showed no mortality with tumor recurrence from 1 patient after 16 months. Conclusion: OC is a rare sinonasal tumor with neuroepithelial differentiation, its histomorphology is diverse, and the combination of immunohistochemical markers is essential for appropriate diagnosis.
Humans
;
Male
;
Female
;
Middle Aged
;
Paranasal Sinus Neoplasms/chemistry*
;
Biomarkers, Tumor/metabolism*
;
Carcinoma/chemistry*
;
Diagnosis, Differential
;
S100 Proteins
;
DNA Helicases/metabolism*
;
Nuclear Proteins/metabolism*
;
Transcription Factors/metabolism*

Result Analysis
Print
Save
E-mail