xRead - Nasal Obstruction (September 2024) Full Articles

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ICAR SINONASAL TUMORS

TABLE XXXIII.4 Summary of the diagnostic utility of imaging studies for the detection of recurrence in sinonasal malignancies. Study Date Modality Site Sensitivity Specificity PPV NPV Gil et al. 216 2007 FDG-PET/CT Primary site 77% 81% 83% 76% Harvey et al. 420 2010 FDG-PET/CT Primary site 100% 40% 54% 100% Khalili et al. 418 2016 CT Local NR NR 44% NR FDG-PET/CT Local NR NR 46% NR MRI Local NR NR 84% NR Lamarre et al. 197 2012 FDG-PET/CT All sites 90% 90% NR NR FDG-PET/CT Local 77% 84% 56% 93% FDG-PET/CT Regional 100% 89% NR NR FDG-PET/CT Distant 83% 95% 63% 98% Ozturk et al. 2205 2019 FDG-PET/CT Local 84% 95% 84% 95% FDG-PET/CT Regional 91% 99% 91% 99% FDG-PET/CT Distant 81% 99% 97% 96% Rhoet al. 2204 2010 FDG-PET/CT Local 86% 93% 86% 93% Workman et al. 421 2017 FDG-PET/CT All sites 75% 96% 43% 99%

spective study of publicly available databases or registries. Prospective trials constitute only a small fraction of the evidence base limited to more common pathologies while neglecting rarer entities. Moreover, many principles rel evant to oncologic care in the sinonasal tract have been gleaned from research focused on tumors in other sites of the head and neck, which at best only incorporate a subset of patients with sinonasal primaries. Recent under standing for need to classify sinonasal tumor types based upon pathophysiology—for example, specific molecular mutations—combined with the relative rarity of sinonasal tumors underscores not only the need for more in-depth studies but also collaborative multicenter investigations in order to collect sufficient numbers of cases and fully capture the breadth of each tumor type. Contemporary understanding of cancer biology driven by genomic and molecular signatures continues to evolve across all fronts, and sinonasal oncology has benefitted tremendously from this surge in knowledge and new tech niques. As part of the wave of precision medicine common to all tumor research is understanding and providing prog nostic and treatment data based on tissue analysis. 421,2206 This is a multidisciplinary, potentially multicenter, effort that would require the creation and maintenance of tis sue biospecimen banks and an infrastructure for patient recruitment, tissue collection and processing, molecular analysis, and critical interpretation of the resulting data. A Basic/translational research opportunities

This approach has recently been applied to IP research, which is more prevalent than malignancies, and has drawn new insights in our understanding of IP pathogen esis and prognosis. 659,669,1140 Recent developments in the ability to perform single-cell RNA sequencing have pro vided novel insights into heterogeneity within skull base tumors as well as the surrounding host tissues, which may have value in sinonasal oncologic research as well. 2207–2209 Complementary to this endeavor is the identification and validation of novel biomarkers for sinonasal tumors, such as predicting clinical behavior or screening for recurrence. With increasing availability of next-generation sequenc ing capabilities—including single-cell sequencing—and bioinformatic approaches, the potential for significant new insights into pathogenesis and predictors of treatment response and immunotherapies has never been greater. We identify as ongoing research needs in a tumor-specific manner: ∙ Understanding for the tumor microenvironment at the single-cell level of the heterogeneity in tumor genetics and epigenetics, the surrounding mucosal environment, and the inflammatory response. ∙ Synthesis of genomic/molecular data with clinicopatho logic behavior, response to treatment, and long-term outcomes. ∙ Application of new bioinformatic techniques to assimi late and interpret complex genomic data. ∙ Development of preclinical models (e.g., cell lines, in vitro models, animal) of sinonasal cancer biology that can be used to study tumor behavior and treatment response.