xRead - Nasal Obstruction (September 2024) Full Articles

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ICAR SINONASAL TUMORS

TABLE I.1 Summary of aggregate grades of evidence surrounding histopathology-based management of sinonasal malignancies.

Treatment modality

Category

Histopathology

AGE Recommendation Specific indications

Squamous cell carcinoma

DN-SCC

IC

C Option

Locally advanced disease (e.g., orbit or skull base invasion) Primary modality Endoscopic surgery option

C a

Recommendation a

Sx

aRT

C Recommendation Locally advanced disease High-grade tumors CRT considered for extranodal extension and/or positive margins

dCRT

C Option

Select early-stage disease Unresectable disease Poor surgical candidates

END/ENI

C Option

Advanced T stage tumors (particularly maxillary sinus primary)

Adenocarcinoma and salivary gland malignancies

ITAC

IC Sx

C Option

Functional P53 protein

B

Recommendation Primary modality

aRT

C Option

Advanced-stage disease (pT3–4) High-grade tumors Positive surgical margins

Non-ITAC

Sx

C Recommendation Primary modality C Recommendation Advanced-stage disease High-grade tumors

aRT

IC considered for functional P53 protein

ACC

Sx

C Recommendation Primary modality

GTR acceptable in place of negative margins

aRT

C Recommendation Advanced-stage disease Positive margins Perineural invasion D No recommendation Salvage setting

Sarcoma

Pediatric

Sx

rhabdomyosarcoma

RT

B B

Recommendation Primary modality

C

Recommendation

Adult

Sx

D No recommendation Salvage setting

rhabdomyosarcoma

CRT

C Option

Primary modality Abstracted from pediatric literature Locally advanced disease

IC

C Option

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