Aykut A. Unsal

Laryngeal chondrosarcoma: A systematic review of 592 cases

Laryngeal chondrosarcomas are rare entities that arise from the cartilaginous structures of the larynx, including the cricoid, thyroid cartilage, epiglottis, and arytenoid cartilages. These tumors represent a minority of malignancies involving the larynx and can be mistaken for benign pathologies. The treatment has historically been surgical excision, often by total laryngectomy. This review investigates treatment modalities and patient outcomes.

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.

A Population-Based Analysis of Survival for Sinonasal Rhabdomyosarcoma

Objectives Literature detailing factors affecting survival in sinonasal rhabdomyosarcoma (SNRMS) is limited due to its rarity. We analyze the demographics, potential prognostic factors, overall survival, and treatment efficacy of SNRMS. Study Design and Setting Administrative database study. Methods SNRMS was queried in the SEER database (1973-2013; Surveillance, Epidemiology, and End Results). Data were analyzed for demographic and clinicopathologic trends. Kaplan-Meier model was utilized for assessing survival. Results A total of 286 cases of SNRMS were identified. The median age at diagnosis was 24.5 years, and the mean tumor size was 5.1 cm. Overall 5-, 10-, and 20-year disease-specific survival was 35.1%, 25.4%, and 12.0%, respectively. Regional lymph node involvement was present at diagnosis in more than half of cases (54.3%) and distant metastasis in 32.2% of cases. Alveolar rhabdomyosarcoma (54.9%) and embryonal rhabdomyosarcoma (23.8%) were the primary histologies. Alveolar-type SNRMS was more likely than the embryonal type to metastasize to distant sites (41.7% vs 24.1%), and it possessed poorer 5-year survival (29.2% vs 45.6%). Distant metastasis decreased 5-year survival from 35.1% to 3.8%, whereas lymph node involvement did not significantly affect survival. Patients <10 years old had the highest survival rates. Primary tumor origin by subsite did not significantly affect survival. Smaller tumor sizes and earlier Intergroup Rhabdomyosarcoma Study Group stages were associated with improved outcomes. Surgical therapy had the highest survival rates. Conclusion SNRMS has overall poorer prognosis than all other parameningeal rhabdomyosarcomas studied. Age <10 years, smaller tumor sizes, lack of distant metastasis, localized tumors, earlier Intergroup Rhabdomyosarcoma Study Group stages, and embryonal histology were all associated with improved outcomes.

Frontal Sinus Malignancies A Population-Based Analysis of Incidence and Survival

Objective Primary neoplasms originating in the frontal sinus are rare. As such, existing literature describing frontal sinus malignancies (a subset of frontal sinus neoplasms) is limited. Prognostic implications of these malignancies are difficult to determine. This study seeks to analyze trends in epidemiology, clinicopathology, incidence, and survival for these rare malignancies. Study Design Retrospective database analysis. Methods The SEER 18 database (Surveillance, Epidemiology, and End Results; 1973-2012) was searched for frontal sinus malignancies from 1973 to 2012 and analyzed for demographic and clinicopathologic trends. The Kaplan-Meier model was utilized for survival analysis. Results A total of 171 cases of frontal sinus malignancies were identified. Incidence was 0.011 per 100,000 individuals. The mean age at diagnosis was 61.1 years, with males constituting the majority of cases (61.4%). 80.1% of patients were white, 9.4% Asian, and 8.2% black. The average tumor size was 3.8 cm. The most common histology encountered was squamous cell carcinoma (39.8%). Overall 5-year disease-specific survival was 44.2%. Five-year disease-specific survival was highest for mature B-cell non-Hodgkin’s lymphomas (72.3%) and lowest for adenocarcinomas (15.4%). Conclusions Malignant tumors of the frontal sinus are rare and are more common in males. Squamous cell carcinoma is the most common entity encountered. Of the 4 most common histologies, survival is best for mature B-cell non-Hodgkin’s lymphomas and worst for adenocarcinomas.

Laryngeal adenosquamous carcinoma: A population-based perspective.

Adenosquamous carcinoma (ASC) is a rare entity, with fewer than 100 cases having been reported in the upper aerodigestive tract. Thus, no large samples characterizing its clinical behavior are available in the literature. Investigation of ASC has been further limited by difficulty in establishing histopathologic diagnosis. Our objective was to use a national population‐based resource to evaluate patient demographics, clinical behavior, incidence, and survival for laryngeal adenosquamous carcinoma (LASC).

Sinonasal adenoid cystic carcinoma: a population‐based analysis of 694 cases

Currently, limited literature exists about sinonasal adenoid cystic carcinoma (SNACC). In this study, we analyze the demographics, survival, and treatment efficacy of this rare entity.

Population-based trends in outcomes in adenoid cystic carcinoma of the oral cavity

PURPOSE Adenoid cystic carcinoma (ACC) is a rare malignant epithelial neoplasm of secretory glands of the upper aerodigestive tract. It accounts for 3-5% of head and neck malignancies and most commonly arises from the minor salivary glands of the oral cavity. The clinical behavior of ACC from specific anatomic subsites, including the oral cavity, is not well described in the literature. We aim to elucidate patient demographics, clinicopathologic features, incidence, and survival trends for oral cavity ACC (OCACC). METHODS Retrospective population-based analysis of OCACC in the SEER database between 1973 and 2012. RESULTS 1066 OCACC patients were identified, of which 57.7% were female (P<0.0001). Incidence was 0.049 per 100,000. Whites were most commonly affected (81.1%). The hard palate was the most commonly involved subsite (44.1%). Nodal involvement was seen in 8.4% of cases and distant metastasis was present in 6.2% of cases at the time of presentation. Disease-specific survival (DSS) rates at 1, 5, 10, 15, and 20years were 97.4%, 83.9%, 69.9%, 57.6%, and 46.2%, respectively. Females had a higher 5-year DSS (87.8%) than males (78.4%, P=0.0004). Cases treated with surgery had a favorable prognosis regardless of whether they received radiotherapy (P<0.0001). Nodal involvement reduced 5-year DSS by 51.6% (P<0.0001), while distant metastasis reduced 5-year DSS by 46.4% (P<0.0001). CONCLUSIONS OCACC is a rare malignancy with females and whites being more commonly affected. At presentation, regional and distant metastases are uncommon. Poor prognostic indicators include male gender, nonsurgical therapy, nodal involvement, and distant metastasis.

Cutaneous squamous cell carcinoma of the lip: A population-based analysis

The role of cumulative ultraviolet (UV) radiation in cutaneous squamous cell carcinoma of the lip (CSCCL) is well understood. This study seeks to evaluate overall survival as well as incidence and demographics across geographic regions, given differences in UV exposure across the United States.

Do geographic differences or socioeconomic disparities affect survival in sinonasal squamous cell carcinoma

Squamous cell carcinoma (SCC) is the most common malignancy in the sinonasal tract. We present the first population‐based analysis that examines geographic differences in demographic and clinical characteristics, socioeconomic factors, treatment modality, and disease‐specific survival (DSS) of this entity.

Geographic region: Does it matter in cutaneous melanoma of the head and neck?

The head and neck are two of the most common locations for cutaneous melanoma. We present the first population‐based analysis of geographic differences in anatomic subsite, clinicopathologic and demographical traits, histopathologic subtype, treatment modality, and disease‐specific survival (DSS) of cutaneous head and neck melanoma (CHNM).