Search

Background: To compare the safety and efficacy between endoscopic sinus surgery and different biologics in treating chronic rhinosinusitis with nasal polyps in adults by reviewing the existing clinical trials. Methods: Data extraction and risk of bias assessment were conducted by 2 independent reviewers according to the PRISMA recommendations and any disagreement was resolved by a third investigator. Outcomes were measured through a random‐effects model. We searched Embase, Web of Science, MEDLINE, Cochrane, and other relevant sources from its inception to April 30, 2022. We included randomized controlled trials(RCTs) involving endoscopic sinus surgery (ESS) or biologics in treating adult patients with chronic rhinosinusitis with nasal polyps. Studies involving other miscellaneous diseases, non‐RCT design, and insufficient participants or follow‐up were excluded. Results: In this systematic review, five RCTs and 1748 patients were included. All the biologics, as well as ESS, could significantly improve key nasal outcomes in CRSwNP both at 6 months and 1 year. Dupilumab exhibited better efficacy than ESS in improving SNOT‐22 scores at one year. However, ESS showed superiority over three biologics in improving nasal congestion scores (NCS) at two various time points, except for better efficacy of Dupilumab at 1 year. For the loss of smell scores, a greater improvement was observed in the Dupilumab cohort compared with other biologics and even ESS counterparts. Safety analysis showed no significant difference between the ESS cohort and biologic treatment. Conclusions: In summary, ESS showed comparable improvement in quality of life and symptoms to Omalizumab, Mepolizumab, and Benralizumab. Dupilumab seems to be more effective than ESS in selected items, whereas head‐to‐head trials and real‐world studies are urgent to compare their efficacy. Our findings also showed that biologics could be applied as alternative or adjuvant therapy for uncontrolled severe CRSwNP. [ABSTRACT FROM AUTHOR]

Objective: Sinonasal melanoma (SMM) is a rare but aggressive malignancy with 5‐year overall survival (OS) rates below 40% in published studies. However, the clinicopathological predictors of the prognosis of SMM remain undefined. We aimed to establish a model to predict the survival outcomes of SMM. Methods: We searched the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with SMM between 1975 and 2016. Data on patient demographics, treatment modalities, and survival outcomes were retrieved. Risk factors for OS were evaluated by survival and Cox regression analyses. We also developed and validated a nomogram for OS, and compared its performance with that of conventional staging systems. Results: Overall, 305 SMM patients were included in this population‐based study. Multivariate Cox regression showed that primary site, American Joint Committee on Cancer stage, radiotherapy, and surgery were significant risk factors for survival. A nomogram was established using the regression model. The C‐indices, areas under the receiver operating characteristic curves, calibration plots, and decision curve analysis demonstrated reliable performance of the nomogram. Conclusion: The nomogram predicting survival outcomes of SMM patients based on clinical information showed good discriminative ability and prognostic accuracy compared with conventional stage classifications. Our nomogram could be used to predict the survival probabilities for SMM patients at different timepoints. Level of Evidence: 2b. [ABSTRACT FROM AUTHOR]

Background: Minor salivary gland cancer (MiSGC) is a group of tumors with varied disease course in the head and neck. We evaluated the risk of a second primary malignancy (SPM) in MiSGC patients and identified possible prognostic factors for survival using a large population database. Methods: We used the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) data to evaluate the risk and prognosis of SPM in patients diagnosed with MiSGC. Results: The risk of SPM increased in MiSGC patients compared with the endemic rate. The risk of SPM was slightly greater in female patients and who underwent radiotherapy. Age at primary diagnosis, sex, race, year of diagnosis, SEER stage, radiotherapy, SPM, histology, and tumor site were significant survival prognostic indicators of MiSGC patients. Conclusion: Radiotherapy and female sex were risk factors for SPM after MiSGC. Long‐term surveillance for SPM was important in MiSGC patients. [ABSTRACT FROM AUTHOR]

Background: Recurrent nasopharyngeal carcinoma (rNPC) is mainly managed with re‐irradiation or salvage surgery. Endoscopic resection is generally considered as the preferred surgical treatment, whereas a standard treatment modality has yet to be established. This article is aimed to summarize the treatment outcomes of endoscopic rNPC resection. Methods: Major medical databases including PubMed, EMBASE, Cochrane Central Library, Web of Science, and 2 major Chinese databases, CNKI and Wanfang, were searched for studies on endoscopic rNPC resection. Main characteristics of study and outcomes of interest were retrieved from articles meeting the selection criteria for meta‐analysis. Results: A total of 761 articles were identified through the initial systematic research. The combined 1‐year, 2‐year, and 5‐year overall survival (OS) rates were 97%, 92%, and 73% with random effect model, respectively. The combined 2‐year and 5‐year disease‐free survival (DFS) rates were 81% and 62%, respectively. Meta‐regression analysis showed that high recurrent tumor (rT) stage (rT3 to rT4) case proportion was a correlative factor of heterogeneity. Combined 2‐year OS rate in rT1, rT2, rT3, and rT4 patients were 100%, 87%, 78%, and 38%, respectively. Combined 2‐year DFS rate in rT1 and rT2 patients were and 96% and 86%, respectively. Conclusion: The combined OS and DFS rates of rNPC patients treated with endoscopic nasopharyngectomy were summarized and reported in our study. This meta‐analysis indicated that endoscopic nasopharyngectomy has comparable and possibly better treatment outcomes than intensity‐modulated radiotherapy (IMRT). Therefore, the result of our study indicated that randomized controlled trials (RCTs) are needed in rNPC patients to compare treatment outcomes of endoscopic nasopharyngectomy vs IMRT. [ABSTRACT FROM AUTHOR]

A left atrial myxoma was found and removed in a 47-year-old woman admitted for acute ischemic cerebrovascular disease, without family history of cardiac tumor. Follow-up echocardiography, 15 months later, demonstrated a new myxoma in the left ventricle. [ABSTRACT FROM AUTHOR]