International, Multi-Institutional Evaluation of Practice Patterns and Outcomes for Recurrent and Metastatic Sinonasal Undifferentiated Carcinoma.

Objectives: The aims of this study were to analyze the clinical characteristics of patients with recurrent and metastatic sinonasal undifferentiated carcinoma (SNUC) and evaluate the current treatment strategies to help guide future management.

Design: This is a retrospective cohort study.

Setting: The study was conducted at six international tertiary treatment centers.

Safety and Efficacy Findings From a Phase Ib/II Study of ASP-1929 Photoimmunotherapy With Pembrolizumab in Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma.

Background: ASP-1929 photoimmunotherapy-cetuximab conjugated to IRDye 700DX and red light (690 nm) for localized drug activation-results in rapid, selective cell killing.

Methods: This phase Ib/II open-label study evaluated ASP-1929 photoimmunotherapy plus pembrolizumab in patients with recurrent/metastatic HNSCC (≥ 1 accessible lesion, PD-L1 combined positive score ≥ 1, ineligible for standard locoregional therapy). Primary objectives were safety/tolerability and objective response rate (ORR).

Enhancing Diagnostic Accuracy in Sinonasal Neuroendocrine Tumors: The Case for DOTATATE PET Over FDG PET.

Neuroendocrine tumors (NET) are a heterogeneous group of neoplasms that arise from neuroendocrine cells and commonly originate in the GI tract, lungs, and pancreas, but can also present in the skull base and paranasal sinuses. While fluorodeoxyglucose positron emission tomography (FDG PET) scans are routinely used in the evaluation of sinonasal malignancies, their limitations in detecting recurrences near the cranium and cervical lymph node metastases in NETs such as olfactory neuroblastoma (ONB) and sinonasal neuroendocrine carcinomas (SNEC) have prompted the search for an alternative imaging modality. Somatostatin receptor 2 (SSTR2) is a membrane-bound G protein expressed in several types of neuroendocrine and neural cells.

Current Trends in the Management of Recurrent Nasopharyngeal Carcinoma.

Background: Recurrent nasopharyngeal carcinoma (NPC) is associated with challenges in treatment due to the complex anatomic location and impact of prior treatment modalities such as radiation therapy. The purpose of this review is to discuss modern treatment strategies for recurrent NPC, potential challenges, and outcomes.

Methods: A narrative review was performed, evaluating management strategies of recurrent NPC, survival measures, and advancements in treatment considerations.

Exploring perspectives on skull base chordoma management: a modified Delphi approach to consensus.

Objective: Current treatment for skull base chordomas utilizes both surgical resection and adjuvant radiation, but recent studies have demonstrated evidence that has brought the use of adjuvant radiotherapy into question. Chordomas differ greatly in molecular makeup and proliferation. These factors have led to significant variation in management across providers.

Expert Strategies: Skull Base Reconstruction-Global Perspectives, Insights, and Algorithms through a Mixed Methods Approach.

Objective: There is limited consensus on endoscopic skull base surgery (ESBS) reconstruction principles. This study aims to generate comprehensive themes regarding ESBS reconstruction by pooling the experiences of ESBS experts, with comparison to a literature review of current published evidence.

Methods: Structured qualitative interviews of ESBS experts regarding postoperative management and reconstruction of various defect locations were conducted.

The skull base chordoma patient reported outcome survey (sbCPROS): a patient-centered, disease-specific tool for assessing quality of life in chordoma patients.

Purpose: Chordomas are rare malignant tumors arising from the embryological notochord that present most frequently in the lumbosacral spine, followed by the skull base, with an overall 1/1,000,000 incidence. These tumors and their treatment significantly affect quality of life (QOL) due to intricate anatomical locations and aggressive treatment regimens. Despite these challenges, there are currently no disease-specific patient-reported outcome (PRO) surveys for chordomas.

Postoperative Management Following Endoscopic Skull Base Reconstruction: A Multidisciplinary Cross-Sectional Survey.

Background: There is limited consensus on management protocols and practice patterns following endoscopic skull base surgery (ESBS).

Methods: An online-based survey focusing on ESBS practice patterns was anonymously distributed to the American Rhinologic Society, North American Skull Base Society, and American Head and Neck Society Skull Base Section membership.

Results: A total of 130 surgeons (81.

Resectable Sinonasal Mucosal Melanoma in the Immunotherapy Era: Upfront Surgery vs. Neoadjuvant Therapy.

Objective: We aim to evaluate outcomes for patients with resectable SNMM treated in the immunotherapy era.

Methods: Thirty-seven patients with resectable SNM were identified using our institutional database between 2016 and 2023.

Results: Patients receiving neoadjuvant Ipi/Nivo (46%, n = 17) were more likely to have disease involving the sinuses and/or the skull base (71% vs.

Phase II Trial of Induction Chemotherapy for Advanced Sinonasal Squamous Cell Carcinoma.

Purpose: Outcomes after primary surgery for advanced sinonasal squamous cell carcinoma (SCC) are poor. We tested whether induction chemotherapy (IC) can improve disease control or organ preservation.

Patients And Methods: A phase II trial evaluated previously untreated patients with stage II to IV, M0 sinonasal SCC.

Impact of Previous Surgery and/or Radiation Therapy on Endoscopic Reconstruction Outcomes.

Background And Objectives: The impact of prior local therapies, including radiation and surgery, on reconstruction outcomes after endonasal surgery is currently not well known. Reconstruction nuances in the preoperative setting merit further evaluation to avoid potential postoperative complications that can hinder overall tumor management and negatively impact patient outcome. We sought to determine whether prior treatments increase risk of reconstruction-related postoperative morbidity and to evaluate the effectiveness of our current treatment paradigm for skull base reconstruction.

A prospective cohort study on stereotactic radiotherapy in the management of dural recurrence of olfactory neuroblastoma.

Background: Treatment for dural recurrence of olfactory neuroblastoma (ONB) is not standardized. We assess the outcomes of stereotactic body radiotherapy (SBRT) in this population.

Methods: ONB patients with dural recurrences treated between 2013 and 2022 on a prospective registry were included.

Sinonasal NUT carcinoma: A consecutive case series and systematic review.

Background: Sinonasal NUT carcinoma is an extremely rare, lethal malignancy with limited literature.

Methods: A case series was conduction of all patients with sinonasal NUT carcinoma at a single institution between 2010 and 2022. Survival and associated were evaluated.

Neurocognitive Functioning of Patients with Sinonasal and Nasopharyngeal Cancers Treated With Multimodality Therapy.

 Few recent studies have examined neurocognitive functioning (NCF) in patients with sinonasal and nasopharyngeal cancers (NPCs) prior to and following multimodality therapy or the potential differences in NCF by disease variables such as disease site.  The objective of this study is to determine rates of NCF impairments prior to and following multimodality therapy, declines in NCF following radiotherapy (RT), and possible differences in NCF by the disease site.  We conducted a retrospective chart review of 39 patients with sinonasal and NPCs who underwent comprehensive neuropsychological evaluations.

Does Time to Initiation of Adjuvant Radiotherapy Affect Reconstruction Outcomes after Endoscopic Resection of Skull Base Malignancies?

 It is unclear if the length of the time interval to initiation of adjuvant radiation therapy (RT) after endoscopic endonasal surgery affects reconstruction outcomes. In this study we present our experience with adjuvant RT after endoscopic endonasal procedures, to determine if the time to RT after surgery impacts post-RT reconstruction complication rates.  A retrospective cohort study of 164 patients who underwent endoscopic endonasal surgery between 1998 and 2021 was conducted.

Current status of sinonasal cancer survivorship care.

Sinonasal cancer is a heterogeneous orphan disease of diverse histologies, each with distinct clinical, oncologic, and toxicity profiles. Because of the comparative rarity of these cancers, sinonasal cancers are treated as a grouped diagnosis despite their clinical and biological heterogeneity. Multimodality treatment with a combination of surgery, chemotherapy, and/or radiotherapy is the standard-of-care for advanced-stage patients but there are few surveillance or follow-up practice guidelines or formalized survivorship care pathways.

Predictors of postoperative performance status after surgical management of infratemporal fossa malignancies.

Infratemporal fossa (ITF) tumors are difficult to access surgically due to anatomical constraints. Moreover, aggressive ITF carcinomas and sarcomas necessitate aggressive treatment strategies that, along with tumor-related symptoms, contribute to decreases in patient performance status. To assess factors that predict postoperative performance in patients undergoing surgery for ITF tumors.

Updates in management strategies of locally advanced sinonasal malignancy.

Purpose Of Review: Sinonasal tumors are a rare heterogenous group of pathologies with poor prognosis. In recent years better definition and understanding of histology, molecular classification, biological behavior and advances in therapy have resulted in improved prognosis. The purpose of this review is to give an updated summary of the recent advances in treatment, and where relevant, with references to pathology classifications.