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Tytuł:
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Nasopharyngeal Angiofibroma Staging with a Novel Nominal Basis: An 18-Year Study in a Tertiary Center.
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Autorzy:
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Abdelwahab M; 1 Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA.; 2 Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Overdevest JB; 1 Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA.
Elmokadem A; 3 Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
El-Sisi H; 2 Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
El-Kholy NA; 2 Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Zaki H; 2 Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Kamal E; 2 Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Khafagy Y; 2 Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Tawfik A; 2 Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Eldawoody H; 4 Department of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.; 5 Department of Neurosurgery, Prince Mohamed Bin Abdul-Aziz Hospital, Riyadh, Saudi Arabia.
Hwang P; 1 Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA.
Rakha A; 2 Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
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Źródło:
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Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2019 Aug; Vol. 161 (2), pp. 352-361. Date of Electronic Publication: 2019 Apr 23.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2023- : [Oxford] : Wiley
Original Publication: [Rochester, Minn.] : The Academy, [c1981-
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MeSH Terms:
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Angiofibroma/*pathology
Nasopharyngeal Neoplasms/*pathology
Cohort Studies ; Humans ; Neoplasm Staging ; Retrospective Studies ; Tertiary Care Centers ; Time Factors
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Contributed Indexing:
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Keywords: angiofibroma; juvenile nasopharyngeal angiofibroma; nominal; staging; surgical planning
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Entry Date(s):
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Date Created: 20190424 Date Completed: 20200130 Latest Revision: 20200130
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Update Code:
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20240105
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DOI:
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10.1177/0194599819842155
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PMID:
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31012381
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Objective: To develop a systematic method for anatomic mapping of juvenile nasopharyngeal angiofibroma (JNA) tumors to standardize communication, facilitate surgical planning, and convey prognosis.
Study Design: Retrospective cohort.
Setting: Tertiary referral center.
Subjects and Methods: Following Institutional Review Board approval, we performed a retrospective review of radiologic and angiographic data of patients with JNA presenting to the Department of Otolaryngology-Head and Neck Surgery, Mansoura University, from 2001 to 2017. All patients underwent angiography with embolization and had >1-year follow-up. Based on frequently involved anatomic sites and factors predictive of prognosis, the NSF-COR staging system (nose/nasopharynx, sinus, fossa-cranium, orbit, residual internal carotid artery supply) was developed to explicitly convey anatomic site of involvement and presence of residual vascularity. We validated the NSF-COR staging system against other systems with Pearson chi-square test based on risk factors and clinical outcomes of blood transfusion volume, recurrence, and JNA resectability.
Results: Fifty-four patients met inclusion criteria, where all primary cases (100%) demonstrated nose/nasopharynx involvement, followed by sinus (85.2%), natural fossae (85.2%), intracranial (26%), and orbital involvement (16.7%). These sites, with assessment of residual internal carotid artery vascular supply, were used to develop the NSF-COR anatomically based staging system. The components COR showed significant association with clinical outcomes of blood transfusion and recurrence. Contingency coefficients between the NSF-COR staging system and available staging systems showed significant correlations ( P < .05) for prognosis.
Conclusion: The NSF-COR staging system conveys a communicable anatomic map of JNA tumors that integrates residual vascularity of the tumor and demonstrates strong concordance with current staging systems to assess clinical outcomes.
