The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Diana Bell - One of the best experts on this subject based on the ideXlab platform.
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Prognosis and Biology in Esthesioneuroblastoma: the Emerging Role of Hyams Grading System
Current Oncology Reports, 2014Co-Authors: Rami E. Saade, Ehab Y Hanna, Diana BellAbstract:Esthesioneuroblastoma is a sinonasal tumor with distinct clinicopathologic features, multiple facets, and a spectrum of behavior. Characterization of this disease is challenging, and clinically, several staging systems have been used with no consensus on a single scheme. Recently, the Hyams histological grading system has emerged as a promising prognostication tool that offers an added value to stage. This review addresses prognosis and biology in Esthesioneuroblastoma. More specifically, we sought to present a critical appraisal on the value of each of these stratification systems, stage vs. grade, in identifying risk groups and guiding management.
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Esthesioneuroblastoma neuroendocrine carcinoma and sinonasal undifferentiated carcinoma differentiation in diagnosis and treatment
International Archives of Otorhinolaryngology, 2014Co-Authors: Shirley Y Su, Diana Bell, Ehab Y HannaAbstract:Introduction Malignant sinonasal tumors comprise less than 1% of all neoplasms. A wide variety of tumors occurring primarily in this site can present with an undifferentiated or poorly differentiated morphology. Among them are Esthesioneuroblastomas, sinonasal undifferentiated carcinomas, and neuroendocrine carcinomas. Objectives We will discuss diagnostic strategies, recent advances in immunohistochemistry and molecular diagnosis, and treatment strategies. Data Synthesis These lesions are diagnostically challenging, and up to 30% of sinonasal malignancies referred to the University of Texas MD Anderson Cancer Center are given a different diagnosis on review of pathology. Correct classification is vital, as these tumors are significantly different in biological behavior and response to treatment. The past decade has witnessed advances in diagnosis and therapeutic modalities leading to improvements in survival. However, the optimal treatment for Esthesioneuroblastoma, sinonasal undifferentiated carcinoma, and neuroendocrine carcinoma remain debated. We discuss advances in immunohistochemistry and molecular diagnosis, diagnostic strategies, and treatment selection. Conclusions There are significant differences in prognosis and treatment for Esthesioneuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma. Recent advances have the potential to improve oncologic outcomes but further investigation in needed.
Ehab Y Hanna - One of the best experts on this subject based on the ideXlab platform.
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Prognosis and Biology in Esthesioneuroblastoma: the Emerging Role of Hyams Grading System
Current Oncology Reports, 2014Co-Authors: Rami E. Saade, Ehab Y Hanna, Diana BellAbstract:Esthesioneuroblastoma is a sinonasal tumor with distinct clinicopathologic features, multiple facets, and a spectrum of behavior. Characterization of this disease is challenging, and clinically, several staging systems have been used with no consensus on a single scheme. Recently, the Hyams histological grading system has emerged as a promising prognostication tool that offers an added value to stage. This review addresses prognosis and biology in Esthesioneuroblastoma. More specifically, we sought to present a critical appraisal on the value of each of these stratification systems, stage vs. grade, in identifying risk groups and guiding management.
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Esthesioneuroblastoma neuroendocrine carcinoma and sinonasal undifferentiated carcinoma differentiation in diagnosis and treatment
International Archives of Otorhinolaryngology, 2014Co-Authors: Shirley Y Su, Diana Bell, Ehab Y HannaAbstract:Introduction Malignant sinonasal tumors comprise less than 1% of all neoplasms. A wide variety of tumors occurring primarily in this site can present with an undifferentiated or poorly differentiated morphology. Among them are Esthesioneuroblastomas, sinonasal undifferentiated carcinomas, and neuroendocrine carcinomas. Objectives We will discuss diagnostic strategies, recent advances in immunohistochemistry and molecular diagnosis, and treatment strategies. Data Synthesis These lesions are diagnostically challenging, and up to 30% of sinonasal malignancies referred to the University of Texas MD Anderson Cancer Center are given a different diagnosis on review of pathology. Correct classification is vital, as these tumors are significantly different in biological behavior and response to treatment. The past decade has witnessed advances in diagnosis and therapeutic modalities leading to improvements in survival. However, the optimal treatment for Esthesioneuroblastoma, sinonasal undifferentiated carcinoma, and neuroendocrine carcinoma remain debated. We discuss advances in immunohistochemistry and molecular diagnosis, diagnostic strategies, and treatment selection. Conclusions There are significant differences in prognosis and treatment for Esthesioneuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma. Recent advances have the potential to improve oncologic outcomes but further investigation in needed.
Anand K Devaiah - One of the best experts on this subject based on the ideXlab platform.
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treatment of Esthesioneuroblastoma a 16 year meta analysis of 361 patients
Laryngoscope, 2009Co-Authors: Anand K Devaiah, Michael T AndreoliAbstract:Objectives/Hypothesis: This study reviews the published outcomes related to surgical (open, endoscopic, and endoscopic-assisted) and nonsurgical treatment for Esthesioneuroblastoma. Study design: Literature meta-analysis. Methods: A meta-analysis of individual patient data for Esthesioneuroblastoma publications between 1992 (the earliest identified description of endoscopic resection) and 2008 was conducted. A total of 49 journal articles, comprising 1,170 cases of Esthesioneuroblastoma, were included in the study. Criteria for meta-analysis inclusion were five or more patients in a study with sufficient patient data resolution for analysis. Twenty-three studies comprising 361 patients met all inclusion criteria. The overall treatment and outcome at final follow-up of each patient was recorded. Patients were pooled according to treatment techniques and compared to one another using a Kaplan-Meier survival curve and the Mann-Whitney U test to examine differences in follow-up times and publication years. Results: Log-rank tests showed a greater published survival rate for endoscopic surgery compared to open surgery (P = .0019), even when stratifying for publication year (P = .0018). There was no significant difference in follow-up time. Review of Kadish tumor staging for each modality showed larger tumors were more often treated with an open approach, but open and endoscopic survival measures were comparable. Conclusions: These results suggest that endoscopic surgery is a valid treatment method with comparable survival to open surgery. Further prospective analysis will be beneficial.
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Esthesioneuroblastoma endoscopic nasal and anterior craniotomy resection
Laryngoscope, 2003Co-Authors: Anand K Devaiah, Christopher G Larsen, Ossama Tawfik, Paul L Oboynick, Larry A HooverAbstract:Objectives/Hypothesis: The objective was to illustrate the use of endoscopic techniques as an evolving surgical modality in excision of Esthesioneuroblastoma. The authors advocate this method with excision with anterior craniotomy for removal of cribriform plate or anterior cranial fossa tumor extension. Study Design: A retrospective chart review of patients with Esthesioneuroblastoma treated surgically at a tertiary care institution from 1991 to 2002 using this surgical paradigm. Methods: Patients were excluded for nonsurgical treatment or nasal and sinus tumor excision by nonendoscopic techniques. Patient demographics, tumor histological findings, presenting signs and symptoms, staging (Kadish and Dulguerov), postoperative complications, adjunct therapy, and recurrence were examined. Results: Seven of 13 patients with Esthesioneuroblastoma met all inclusion criteria. The average patient age was 47 years, with a male-to-female distribution of 4 to 3. Patients were grouped by tumor stage using Kadish (stages A, B, and C included three, one, and three patients, respectively) and Dulguerov (stages T1, T2, and T4 included three, two, and two patients, respectively) methods. Average follow-up was 62.3 months. All patients had an endoscopic excision of the nasal and sinus component with anterior craniotomy. The most common postoperative complication was temporary mental status change, which was seen in two patients. There were no postoperative deaths. All patients received radiation therapy, and one also received chemotherapy. Two of the seven patients had recurrences. At last follow-up, six patients had no evidence of disease and one was alive with disease. Conclusion: Endoscopic excision of the nasal and sinus component with anterior craniotomy for cribriform or anterior cranial fossa extension is an effective treatment of Esthesioneuroblastoma.
Jack L Gluckman - One of the best experts on this subject based on the ideXlab platform.
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Esthesioneuroblastoma and sinonasal undifferentiated carcinoma impact of histological grading and clinical staging on survival and prognosis
Laryngoscope, 2000Co-Authors: Christopher R Miyamoto, Lyon L Gleich, Paul Williams Biddinger, Jack L GluckmanAbstract:Objectives: Hyams proposed a histological grading system for Esthesioneuroblastoma in which grade I tumors have an excellent prognosis and grade IV tumors are uniformly fatal. The Hyams grading system predated advanced craniofacial techniques, extensive use of immunohistochemistry, and the recognition of sinonasal undifferentiated carcinoma (SNUC) as a distinct entity. Therefore we aimed to determine whether Hyams classification is useful in predicting outcome for Esthesioneuroblastoma and SNUC. Study Design: A retrospective review of cases from 1970 to 1999. Methods: Twenty-six patients (12 with Esthesioneuroblastoma and 14 with SNUC) were reviewed. The Kadish clinical stage was determined, and histopathological slides were reviewed and graded using the Hyams system. Results: Kadish staging was available for 26 patients (2 patients with stage A tumors; 7 with stage B; and 17 with stage C). Of the 8 evaluable patients with Kadish stage A or B tumors, 6 remained disease free for more than 2 years compared with only 5 of the 17 Kadish stage C tumors. Slides were available for Hyams grading in 21 patients (2 patients with grade I tumors; 4 with grade II; 4 with grade III; and 11 with grade IV). Of the 6 patients with Hyams grade I or II tumors, 4 remained disease free for more than 2 years compared with only 4 of the 15 patients with Hyams grade III or IV tumors. Of note, three patients with Kadish stage C tumors (two with Esthesioneuroblastoma, one with SNUC) and two patients with Hyams grade IV tumors (one with Esthesioneuroblastoma and one with SNUC) survived for more than 5 years. Conclusions: Both the Hyams grading system and the Kadish staging system can be used as independent predictors of outcome. Although limited by small numbers, the results of this study demonstrate that patients with either advanced clinical stage or pathological grade of Esthesioneuroblastoma or SNUC have poor prognosis, but that long-term survival is possible in these patients if aggressive treatment is used.
Christopher R Miyamoto - One of the best experts on this subject based on the ideXlab platform.
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Esthesioneuroblastoma and sinonasal undifferentiated carcinoma impact of histological grading and clinical staging on survival and prognosis
Laryngoscope, 2000Co-Authors: Christopher R Miyamoto, Lyon L Gleich, Paul Williams Biddinger, Jack L GluckmanAbstract:Objectives: Hyams proposed a histological grading system for Esthesioneuroblastoma in which grade I tumors have an excellent prognosis and grade IV tumors are uniformly fatal. The Hyams grading system predated advanced craniofacial techniques, extensive use of immunohistochemistry, and the recognition of sinonasal undifferentiated carcinoma (SNUC) as a distinct entity. Therefore we aimed to determine whether Hyams classification is useful in predicting outcome for Esthesioneuroblastoma and SNUC. Study Design: A retrospective review of cases from 1970 to 1999. Methods: Twenty-six patients (12 with Esthesioneuroblastoma and 14 with SNUC) were reviewed. The Kadish clinical stage was determined, and histopathological slides were reviewed and graded using the Hyams system. Results: Kadish staging was available for 26 patients (2 patients with stage A tumors; 7 with stage B; and 17 with stage C). Of the 8 evaluable patients with Kadish stage A or B tumors, 6 remained disease free for more than 2 years compared with only 5 of the 17 Kadish stage C tumors. Slides were available for Hyams grading in 21 patients (2 patients with grade I tumors; 4 with grade II; 4 with grade III; and 11 with grade IV). Of the 6 patients with Hyams grade I or II tumors, 4 remained disease free for more than 2 years compared with only 4 of the 15 patients with Hyams grade III or IV tumors. Of note, three patients with Kadish stage C tumors (two with Esthesioneuroblastoma, one with SNUC) and two patients with Hyams grade IV tumors (one with Esthesioneuroblastoma and one with SNUC) survived for more than 5 years. Conclusions: Both the Hyams grading system and the Kadish staging system can be used as independent predictors of outcome. Although limited by small numbers, the results of this study demonstrate that patients with either advanced clinical stage or pathological grade of Esthesioneuroblastoma or SNUC have poor prognosis, but that long-term survival is possible in these patients if aggressive treatment is used.