Alejandro Vazquez

Sinonasal melanoma: survival and prognostic implications based on site of involvement

Sinonasal melanoma (SNM) is a rare malignancy that commonly presents at an advanced age and has a slight male predominance. Local recurrence has been implicated as a major reason for treatment failure, and there are poor reported 5‐year survival rates. We analyzed the impact of specific location within the sinonasal region on the survival of this rare malignancy.

Polymorphous low‐grade adenocarcinoma of the head and neck: A population‐based study of 460 cases

Polymorphous low‐grade adenocarcinoma (PLGA) is a rare malignant neoplasm of the minor salivary glands. This study analyzes the demographic, clinicopathologic, incidence, and survival characteristics of head and neck PLGA (HN‐PLGA).

Diffuse large B-cell lymphoma of the sinonasal tract: Analysis of survival in 852 cases

PURPOSE Diffuse large B-cell lymphomas (DLBCLs) are rare tumors of the head and neck that often have non-specific presentations and significant morbidity and mortality. In this analysis we use a large cohort to compare the demographic and disease-specific parameters affecting survival and incidence of DLBCLs. METHODS The United States National Cancer Institutes Surveillance, Epidemiology, and End Results (SEER) registry was utilized to extract data regarding sinonasal diffuse large B-cell lymphoma between 1973 and 2009. A total of 852 cases of sinonasal DLBCLs were found. Presenting symptoms, demographics, disease specific survival, relative survival and survival by treatment modality were described for this rare tumor. RESULTS Overall disease specific survival (DSS) at 1-year was 84.7% and at 5 years was 68.0%. DSS was significantly lower for those not treated with radiation therapy, with 1- and 5-year survival rates of 77.3% and 62.5%, versus those treated with radiation therapy, with 1- and 5-year rates of 89.2% and 71.5% (p<0.05). Prognosis was significantly better for patients treated with radiation therapy (HR 0.6, p<0.05) while it was poorer for patients with involvement of multiple sinuses (HR 1.5, 1.8, p<0.05). CONCLUSIONS DLBCLs of the sinonasal tract are rare tumors of the head and neck. Survival is significantly improved for those treated with radiation therapy while the involvement of multiple sinuses is a negative prognostic indicator.

Epithelial-Myoepithelial Carcinoma of the Salivary Glands: An Analysis of 246 Cases

Objective Epithelial-myoepithelial carcinoma (EMC) is a rare neoplasm of the salivary glands. In this study, we aim to examine the demographic, clinicopathologic, and survival features of EMC using a population-based approach. Study Design and Setting Retrospective cohort study. Subjects and Methods The Surveillance, Epidemiology, and End Result (SEER) database (1973-2010) was queried for EMC of the major salivary glands. Data were analyzed with respect to various demographic and clinicopathologic factors. Survival was analyzed using the Kaplan-Meier and Cox proportional hazards models. Results In total, 246 cases were available for frequency analysis and 207 for survival analysis. Mean ± SD age at diagnosis was 63.8 ± 15.4 years. EMC affected females more frequently (57.3%). Distant metastases were present at diagnosis in only 4.5% of cases. Overall disease-specific survival (DSS) at 60, 120, and 180 months was 91.3%, 90.2%, and 80.7%, respectively. Patients with low-grade histology had significantly better survival at 180 months relative to those with high-grade tumors (90.6% vs 0.0%, P = .0246). When stratified by tumor size, patients with lesions >4 cm had the worst survival at 180 months (58.8%, P = .0003). All but 9 of the 207 cases available for survival analysis underwent surgery. A total of 85 patients (41.1%) received radiotherapy in addition to surgery. No survival benefit was noted for patients who received radiotherapy compared with those who did not (P = .4832). Conclusion This report represents the largest series of EMC to date. Despite being regarded as a low-grade, indolent tumor, a significant fraction of our cohort underwent radiotherapy in addition to surgery, with no apparent added survival benefit.

A comparative population‐based analysis of sinonasal diffuse large B‐cell and extranodal NK/T‐cell lymphomas

Diffuse large B‐cell lymphoma (DLBCL) and extranodal natural killer/T‐cell lymphoma (ENKTL) are aggressive tumors. ENTKL is very rare in the United States and often affects the nasal cavity and paranasal sinuses; DLBCL, although more common, rarely occurs in these locations. Our study aims to compare incidence and survival of these lymphomas in the sinonasal cavity.

Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue of the salivary glands: A population-based study from 1994 to 2009

Extranodal marginal zone lymphoma of mucosa‐associated lymphoid tissue (MALT lymphoma) arising from the salivary glands is rare.

Sinonasal squamous cell carcinoma and the prognostic implications of its histologic variants: a population-based study.

Variants of squamous cell carcinoma (SCC) make up 15% of all cases of SCC of the upper aerodigestive tract. There are 5 main histologic variants of SCC in the head and neck region: verrucous (VSCC), papillary (PSCC), spindle cell (sarcomatoid) (SCSC), basaloid (BSCC), and adenosquamous (ASC). Conventional sinonasal SCC has been studied extensively, but far less is known about its major variants.

Extranodal natural killer/T‐Cell lymphoma: A population‐based comparison of sinonasal and extranasal disease

Extranodal natural killer/T‐cell Lymphoma (ENKTL) is a rare, aggressive malignancy that preferentially affects the paranasal region. This study analyzes the demographic, clinicopathologic, incidence, and survival characteristics of sinonasal ENKTL (SN‐ENKTL) and extranasal ENKTL (EN‐ENKTL) in a comparative fashion.

Nasopharyngeal squamous cell carcinoma: a comparative analysis of keratinizing and nonkeratinizing subtypes

Nasopharyngeal squamous cell carcinoma (NPSCC) is uncommon in non‐endemic regions. Two major histologic subtypes are recognized: keratinizing (K‐NPSCC) and nonkeratinizing (NK‐NPSCC). We hypothesize that significant differences exist between the 2 in terms of demographic, clinicopathologic, survival, and prognostic features. We aim to show that differentiating between the 2 subtypes is perhaps the most important first step at the time of diagnosis.

Squamous cell carcinoma of the nasal cavity: A population-based analysis

Squamous cell carcinoma of the nasal cavity (NCSCC) is an infrequent malignancy that has been historically difficult to characterize. This study provides new insight into NCSCC utilizing a population‐based database. We analyze the propensity for cervical and distant metastasis from NCSCC, as well as survival outcomes.