Publications by authors named "Shirley Y Su"

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-IV, M0 sinonasal SCC.

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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.

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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.

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Article Synopsis
  • A global collaborative study reviewed the management and outcomes of malignant skull base tumors, collecting data from 28 institutions involving 3,061 patients.
  • The majority of surgeries utilized an open approach (55%), with endoscopic (36%) and combined techniques (9.6%) being less common, and the overall 5-year survival rates were 65% for overall survival (OS) and 71.7% for disease-specific survival (DSS).
  • Factors such as older age, comorbidities, and the extent of tumor involvement were identified as independent predictors of survival, while adjuvant radiation therapy (RT) emerged as a protective factor in outcomes.
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  • This study examines the use of expanded endoscopic approaches (EEAs) versus open surgical approaches in treating sinonasal malignancies with skull base involvement, focusing on long-term outcomes like extent of resection, overall survival, and disease progression.
  • The research included 42 patients who underwent EEAs and 54 who had open surgeries, matching them anatomically to better compare results while addressing selection bias in previous studies.
  • Findings showed that the EEA group had fewer complications (14.29%) compared to the open surgery group (33.33%), with no significant difference in the extent of resection or overall survival rates between the two methods.
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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.

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 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.

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Article Synopsis
  • - The study aimed to evaluate the safety of induction chemotherapy (IC) for patients with sinonasal cancers that have invaded the brain or caused neurological deficits, analyzing data from 460 patients treated at a cancer center from 1992 to 2020.
  • - Out of the 341 patients who received IC, 40 had brain invasion and 31 had neurological deficits; most patients experienced either partial or complete responses to treatment, with notable improvements in neurological symptoms for some.
  • - Notably, none of the patients had to stop treatment due to worsening neurological conditions, indicating that IC was effectively and safely administered without significant complications related to brain involvement or neurological implications.
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  • Sinonasal neoplasms (both benign and malignant) are complex issues for clinicians, highlighting the need for collaboration to improve patient care, as presented in the International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT).
  • The ICSNT document organizes findings into four main sections: general principles, benign neoplasms, malignant neoplasms, and quality of life, covering 48 specific topics and providing evidence-based recommendations and summaries based on their rigor.
  • This comprehensive document reflects a collective effort from an international team to advance understanding and intervention methods for sinonasal neoplasms, while also identifying future research opportunities.
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  • Limited studies exist on pituitary dysfunction in adults who had radiation therapy for anterior skull base tumors, prompting this research.
  • In a study of 50 patients with sinonasal or nasopharyngeal cancer, 46% exhibited abnormal pituitary hormone levels, with hyperprolactinemia being the most common issue.
  • Higher doses of radiation to specific brain regions were linked to hormonal dysfunction, indicating a possible dose-dependent effect of radiation on pituitary health.
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 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.

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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.

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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.

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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.

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The objective of this study was to report outcomes for 19 consecutive patients with SMARCB1 (INI-1)-deficient sinonasal carcinoma. Patients were treated from 2014 to 2021 and followed for a median of 22.3 months.

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Aims: The purpose of this study was to determine the frequency and associated risk factors of orbital/periocular complications in patients with sinonasal tumour with orbital invasion managed with eye-sparing treatments.

Methods: A retrospective case series of patients with primary sinonasal tumour with orbital invasion from January 2008 to December 2018. Patient factors were compared between the following groups: (1)patients with orbital/periocular complications versus those who did not and (2) patients who needed secondary oculoplastic surgical procedures versus those who did not.

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Background: Cancer centers are regionalizing care to expand patient access, but the effects on patient volume are unknown. This study aimed to compare patient volumes before and after the establishment of head and neck regional care centers (HNRCCs).

Methods: This study analyzed 35,394 unique new patient visits at MD Anderson Cancer Center (MDACC) before and after the creation of HNRCCs.

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Background: Recurrent skull base chondrosarcomas (CSA) are difficult to treat, and limited data are available to help guide subsequent therapy.

Objective: To further characterize the natural history of CSA and identify treatment modalities that were most effective in prolonging progression-free (PFS) and disease-specific survival (DSS).

Methods: We conducted a single-institution retrospective review of patients with recurrent skull base CSA from 1993 to 2021.

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Background: Neoadjuvant checkpoint inhibition (CPI) has recently demonstrated impressive outcomes in patients with stage 3 cutaneous melanoma. However, the safety, efficacy, and outcome of neoadjuvant CPI in patients with mucosal melanoma (MM) are not well studied as MM is a rare melanoma subtype. CPI such as combination nivolumab and ipilimumab achieves response rates of 37-43% in unresectable or metastatic MM but there is limited data regarding the efficacy of these agents in the preoperative setting.

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Soft tissue sarcomas (STS) invading the skull base are rare with little data to guide surgical management. Here we aimed to determine the factors affecting tumor control rates and survival in patients with T4 stage head and neck STS involving the skull base. A retrospective review of STS patients, surgically treated at our institution between 1994 and 2017 was conducted.

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Introduction: Clival malignancies pose particular surgical challenges due to complex skull base anatomy and the involvement of vital neurovascular structures. While endoscopic endonasal approached are widely used, the outcomes for clival malignancies remain poorly understood. In this study we assessed the impact of endoscopic and open surgical approaches on PFS, time to initiation of radiotherapy, KPS, and GTR rates for clival malignancies.

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Purpose Of Review: This article will review functional and QOL outcomes among patients treated predominantly for sinonasal and nasopharyngeal malignancies.

Recent Findings: Treatment advances and interdisciplinary supportive care help to lessen the functional impairments and the reduction in quality of life (QOL) that were once accepted as inevitable tradeoffs for cure. Recent progress in QOL and Patient-Reported Outcome (PRO) instruments for this population will be covered.

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Objective: Patients with recurrent sinonasal cancers (RSNCs) often present with extensive involvement of the skull base and exhibit high rates of subsequent recurrence and death after therapy. The impact of salvage surgery and margin status on progression-free survival (PFS) and overall survival (OS) has yet to be demonstrated. The goal of this study was to determine whether skull base resection with negative margins has an impact on outcomes in the recurrent setting.

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We report clinical, imaging and pathology findings of a patient with leprosy of the great auricular nerve who presented with palpable nodules and numbness of the left ear and scalp. Ultrasound and contrast-enhanced CT imaging of the neck demonstrated diffuse enlargement and enhancement of the great auricular nerve. Biopsy of the enlarged left great auricular nerve revealed granulomatous inflammation with necrosis involving the nerve with rare Fite-positive organisms compatible with mycobacterium.

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Objective: Sinonasal malignancies that extend to the anterior skull base frequently require neurosurgical intervention. The development of techniques for craniofacial resection revolutionized the management of these neoplasms, but modern and long-term data are lacking, particularly those related to the incorporation of endoscopic techniques and novel adjuvant chemotherapeutics into management schema. The present study was performed to better define the utility of surgical management and to determine factors related to outcome.

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