During the last decade, there has been increasing adoption of endoscopic approaches for surgical resection of sinonasal cancer. Despite this growing enthusiasm, the oncologic outcomes for endoscopic resection of sinonasal cancer have not been adequately reported. Most published reports include small case series with short follow-up.^1-6 The majority of these reports focus exclusively on esthesioneuroblastoma, and the results of endoscopic resection of other types of sinonasal cancer are not widely described. The purpose of this study was to determine the oncologic outcomes of patients with sinonasal cancer who were treated with endoscopic resection in the last 15 years at The University of Texas M. D. Anderson Cancer Center, Houston.

BACKGROUND: Sinonasal mucosal melanoma is a rare disease associated with a very poor prognosis. Because most of the series extend retrospectively several decades, we sought to determine prognostic factors and outcomes with recent treatment modalities.METHODS: A retrospective chart review of 58 patients treated for sinonasal melanoma at a tertiary cancer center between 1993 and 2004. The patients were retrospectively staged according to the sinonasal American Joint Committee on Cancer (AJCC) staging system. Demographic, clinical and pathological parameters were identified and correlated with outcomes.RESULTS: There were 35 males and 23 females with a median age of 63 years; 56 patients were treated surgically and 33 received radiation therapy. According to Ballantyne's clinical staging system, 88% of the patients presented with stage I (local) disease. Classification by the AJCC staging classified yielded 27% of the patients with T1, 33% with T2, 21% with T3, and 19% with T4. T‐stage and the degree of tumor pigmentation were associated with a worse survival (P = .0096 and P = .018, respectively), while pseudopapillary architecture was associated with a higher locoregional failure (P = .0144). Postoperative radiation therapy improved locoregional control when a total dose greater than 54 Gy was used (P = .0215), but did not affect overall survival.CONCLUSIONS: Tumor stage according to sinonasal AJCC staging system is an effective outcome predictor and should be the staging system of choice. Postoperative radiation therapy improves locoregional control when a higher dose and standard fractionations are used. Histological features such as pigmentation and pseudopapillary architecture are associated with worse outcome. Cancer 2010. © 2010 American Cancer Society.

BACKGROUND: Mucoepidermoid carcinoma (MEC) is the most common malignancy of the major salivary glands. Prior reports noted histological grade and tumor stage as consistently important prognostic factors. This study reviewed the experience of patients with MEC at the University of Texas MD Anderson Cancer Center to determine the impact of clinical and pathologic findings on disease outcomes.METHODS: A retrospective clinical review was performed of patients with salivary gland MEC treated at a tertiary cancer center from 1990 to 2007.RESULTS: A total of 125 patients were included. The 5‐year overall survival and disease‐free survival of all patients were 79.3% and 76.5%, respectively. Patients with low‐ and intermediate‐grade disease had significantly better overall survival and disease‐free survival than patients with high‐grade disease, but no difference in survival rates was found between low‐ and intermediate‐grade disease. Pathologic results of positive lymph nodes, extracapsular lymph node spread, and perineural invasion were all found to be poor prognostic indicators. On multivariate analysis, advanced disease stage and perineural invasion were found to be the most significant prognostic factors.CONCLUSIONS: Patients with either low‐ or intermediate‐grade tumors uniformly have favorable local control and survival. High histological grade, advanced stage, perineural invasion, positive surgical margins, and submandibular location all portend for poor outcomes in MEC. Further advances in therapy are needed to improve outcomes for high‐grade and advanced‐stage disease. Cancer 2012. © 2011 American Cancer Society.

Research from JAMA Otolaryngology–Head & Neck Surgery — Quality of Life for Patients Following Total Laryngectomy vs Chemoradiation for Laryngeal Preservation