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  • 1
    In: Journal for ImmunoTherapy of Cancer, BMJ, Vol. 4, No. S1 ( 2016-11)
    Type of Medium: Online Resource
    ISSN: 2051-1426
    Language: English
    Publisher: BMJ
    Publication Date: 2016
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  • 2
    In: International Forum of Allergy & Rhinology, Wiley, Vol. 9, No. 7 ( 2019-07), p. 804-812
    Abstract: Orbital cavernous hemangiomas (OCH) are the most common adult orbital tumor and represent an ideal index lesion for endonasal orbital tumor surgery. In order to standardize outcomes reporting, an anatomic‐based staging system was developed. Methods An international, multidisciplinary panel of 23 experts in orbital tumor surgery was formed. A modified Delphi method was used to develop the cavernous hemangioma exclusively endonasal resection (CHEER) staging system with a total of 2 rounds being completed. Results Tumors medial to a plane along the long axis of the optic nerve may be considered amenable for an exclusively endonasal resection. In select cases, tumors may extend inferolaterally if the tumor remains below a plane from the contralateral naris through the long axis of the optic nerve (ie, plane of resectability [POR] ). This definition reached consensus with 91.3% of panelists in agreement. Five stages were designed based on increasing technical resection difficulty and potential for morbidity. Stages were based on the relationship of the tumor to the extraocular muscles, the inferomedial muscular trunk of the ophthalmic artery (IMT), and orbital foramina. Staging by anatomic location also reached consensus with 87.0% of panelists in agreement. Size was not included in the staging system due to the lack of agreement on the contribution of size to resection difficulty. Conclusion Endoscopic orbital tumor surgery is a nascent field with a growing, yet heterogeneous, body of literature. The CHEER staging system is designed to facilitate international, high‐quality, standardized studies establishing the safety, efficacy, and outcomes of endonasal resection of OCH.
    Type of Medium: Online Resource
    ISSN: 2042-6976 , 2042-6984
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
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  • 3
    Online Resource
    Online Resource
    Elsevier BV ; 2017
    In:  International Journal of Pediatric Otorhinolaryngology Vol. 102 ( 2017-11), p. 108-113
    In: International Journal of Pediatric Otorhinolaryngology, Elsevier BV, Vol. 102 ( 2017-11), p. 108-113
    Type of Medium: Online Resource
    ISSN: 0165-5876
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
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  • 4
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 76, No. 14_Supplement ( 2016-07-15), p. 1631-1631
    Abstract: Introduction. Head and neck squamous cell carcinomas (HNSCCs) account for nearly 600,000 deaths worldwide annually and have limited treatment options. Approximately 20% of HNSCCs harbor amplifications of fibroblast growth factor receptor 1 (FGFR1) on chromosome 8p, however FGFR1 amplification by itself does not predict clinical response to FGFR inhibitors. We hypothesized that FGF2, or basic FGF, ligand expression is a better marker of FGFR activation and predictor of response to FGFR inhibitors. Results. A tissue micro array (TMA) of HNSCC patient biopsies was stained and quantitated for FGF2 expression by Aperio ImageScope software. FGF2 was significantly increased in recurrent tissue samples (p = 0.04). We examined a number of immortalized HNSCC cell lines and found that overexpression of both FGF2 and FGFR1 predicted response to the selective FGFR inhibitor PD173074. FGFR inhibition did not cause apoptosis, but rather induced a G0/G1 arrest and growth inhibition. FGFR inhibition also induced a change in cell morphology, with a significant increase in cell size and adherence. The expression of epithelial-to-mesenchymal transition (EMT) proteins was examined and FGF2-FGFR1 activation was associated with a more mesenchymal phenotype. Accordingly, FGFR inhibition reversed invasiveness as measured using the Incucyte WoundMaker scratch assay, suggesting that HNSCCs with FGF2-FGFR1 activation have more metastatic potential. Invasiveness of these cells in vivo was confirmed using orthotopic injection into the buccal pad of NSG mice. Once primary tumors reached 0.8 cm in size, mice were sacrificed and buccal mucosa, lung, liver, and neck tissue were examined post-mortem. All of the injected animals developed local invasion, and distant metastases in the lungs. 5/7 mice also had metastases in the liver and this model is being used to test the ability of FGFR inhibition to prevent metastasis. The mechanism of autocrine FGF2-FGFR1 activation was further explored and FGF2 was found to be secreted in association with extracellular vesicles (ECVs). Interestingly, inhibition of FGFR reduced secretion of ECVs and FGF2, providing a novel approach to target autocrine and paracrine FGFR1 activation within the tumor. We further tested a number of small molecule inhibitors in combination with PD173074 to look for synergistic combinations of kinase inhibitors and found significant synergy between EGFR and FGFR inhibitors suggesting this combination may be most effective in patients with HNSCC. Conclusions. Increased FGF2 in HNSCC patient samples is correlated with recurrent disease. FGF2-FGFR1 activation increases invasiveness through activation of EMT genes both in vitro, and in an orthotopic model. Inhibition of FGF2-FGFR1 reversed the invasive phenotype in vitro and may be an effective therapeutic strategy to reduce metastases in HNSCC patients. Citation Format: Isabel A. English, Jacqueline Martinez, Edward El Rassi, Mark Schmidt, Ellen Langer, Sophia Bornstein, John Gleysteen, Melissa Wong, Brian Druker, Elie Traer. FGF2 activation of FGFR1 in head and neck squamous cell carcinoma is associated with more invasive disease and can be attenuated by FGFR inhibition. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1631.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2016
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    detail.hit.zdb_id: 410466-3
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  • 5
    In: Head & Neck, Wiley, Vol. 39, No. 6 ( 2017-06), p. 1106-1112
    Abstract: Treatment of head and neck cancer is complex, and a multidisciplinary clinic may improve the coordination of care. The value of a head and neck multidisciplinary clinic has not yet been established in oropharyngeal squamous cell carcinoma (SCC). Methods A retrospective review was conducted of Veterans Affairs patients with oropharyngeal SCC undergoing concurrent chemoradiation before and after implementation of the head and neck multidisciplinary clinic. Results Fifty‐two patients before and 54 patients after multidisciplinary clinic were included in this study. Age, tobacco use, and p16+ status were similar between groups. With multidisciplinary clinic, time to treatment decreased, and utilization of supportive services, including speech pathology, dentistry, and nutrition increased. The 5‐year disease‐specific survival rate increased from 63% to 81% ( p = .043) after implementation of the multidisciplinary clinic. Multivariate analysis showed that disease stage ( p = .016), p16 status ( p = .006), and multidisciplinary clinic participation ( p = .042) were predictors of disease‐specific survival. Conclusion Implementation of a multidisciplinary clinic improved care coordination and disease‐specific survival in patients with oropharyngeal SCC. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1106–1112, 2017
    Type of Medium: Online Resource
    ISSN: 1043-3074 , 1097-0347
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2017
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  • 6
    Online Resource
    Online Resource
    Wiley ; 2018
    In:  The Laryngoscope Vol. 128, No. 12 ( 2018-12), p. 2681-2687
    In: The Laryngoscope, Wiley, Vol. 128, No. 12 ( 2018-12), p. 2681-2687
    Abstract: To evaluate the impact of age on patient‐reported quality of life (QOL) following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Study Design Prospective cohort study. Methods Six hundred thirty‐six patients with CRS were recruited from 11 otolaryngologic practices and completed the sinonasal‐specific, 22‐item Sino‐Nasal Outcome Test‐22 (SNOT‐22) and general health‐related EuroQol 5‐Dimension (EQ‐5D) questionnaires at baseline and 12 and 24 months after ESS. Patients were grouped chronologically to determine whether age at time of ESS was associated with clinical outcomes. Results Ages ranged from 18 to 80 years (mean ± standard deviation = 48.5 ± 14.4). Improvement was observed in postoperative SNOT‐22 scores at 12 and 24 months for all decades of life. Similar improvements were observed for EQ‐5D‐based health utility value (HUV) scores in all decades of life, except for the eldest cohort (ages 70–80, N = 33), who did not exceed the minimal clinically important difference at either 12 or 24 months following ESS. In regression analysis, age was not associated with sinonasal‐specific outcomes (change in SNOT‐22 scores) at 12 ( P  = .507) or 24 months ( P  = .955). In general health‐related outcomes, however, age was significantly associated with change in EQ‐5D‐based HUV scores from baseline to 12 months following ESS after adjusting for patient demographics, comorbidities, and surgical history ( P  = .049). Conclusions This study demonstrates that ESS for adult CRS sufferers offers improved QOL outcomes through the eighth decade of life. The impact of comorbidities on QOL needs to be carefully considered when assessing older patients for sinus surgery. Level of Evidence 2b Laryngoscope , 128:2681–2687, 2018
    Type of Medium: Online Resource
    ISSN: 0023-852X , 1531-4995
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2026089-1
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  • 7
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2015
    In:  Endocrine Pathology Vol. 26, No. 2 ( 2015-5), p. 170-177
    In: Endocrine Pathology, Springer Science and Business Media LLC, Vol. 26, No. 2 ( 2015-5), p. 170-177
    Type of Medium: Online Resource
    ISSN: 1046-3976 , 1559-0097
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2015
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  • 8
    In: International Forum of Allergy & Rhinology, Wiley, Vol. 6, No. 3 ( 2016-03), p. 287-292
    Abstract: The Brief Smell Identification Test (BSIT) is an abbreviated version of the Smell Identification Test (SIT) used to assess olfactory function. Although the BSIT can be efficiently administered in under 5 minutes, the accuracy of the BSIT in relation to the SIT in patients with chronic rhinosinusitis (CRS) is unknown. Methods Patients with CRS were recruited as part of an ongoing multi‐institutional observational cohort study. A total of 183 participants provided both BSIT and SIT olfactory function scores during initial enrollment. Linear associations between BSIT and SIT scores were evaluated using Pearson's correlation coefficients ( r p ). The sensitivity, specificity, and accuracy of BSIT scores were determined using SIT scores as the “gold standard.” Results A strong bivariate linear association was found between BSIT and SIT scores ( r p = 0.893; p 〈 0.001) for all participants. A significantly lower proportion of patients were identified as having abnormal olfaction using the BSIT compared to the SIT (47% vs 68%, respectively; p 〈 0.001). Using the currently defined score of ≤8 as a cut‐point for abnormal olfactory function, the BSIT demonstrated a sensitivity of 63% and specificity of 88% with an overall accuracy of 71%. Increasing the cut‐point to ≤9 resulted in an increased sensitivity of 86%, a specificity of 76%, and an improved overall accuracy of 83%. Conclusion In patients with CRS, BSIT scores strongly correlate with SIT scores; however, the BSIT underestimates olfactory dysfunction as defined by the suggested cut‐point of ≤8. Increasing the cut‐point to ≤9 increased the sensitivity and accuracy of the BSIT.
    Type of Medium: Online Resource
    ISSN: 2042-6976 , 2042-6984
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2016
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  • 9
    Online Resource
    Online Resource
    Wiley ; 2016
    In:  International Forum of Allergy & Rhinology Vol. 6, No. 4 ( 2016-04), p. 414-422
    In: International Forum of Allergy & Rhinology, Wiley, Vol. 6, No. 4 ( 2016-04), p. 414-422
    Abstract: Sleep impairment is highly prevalent in patients with chronic rhinosinusitis (CRS). Although endoscopic sinus surgery (ESS) has been shown to improve overall patient‐reported sleep quality, the postoperative impact on individual sleep symptoms remains unclear. Methods Patients with medically‐recalcitrant CRS who elected to undergo ESS were prospectively enrolled into a multi‐institutional, observational cohort study. Sleep‐related symptom severity and treatment outcomes were assessed using the sleep domain questions within the 22‐item Sino‐Nasal Outcome Test (SNOT‐22). Results A total of 334 participants met criteria and were followed postoperatively for an average of 14.5 ± 4.9 months (mean ± standard deviation [SD]). Mean SNOT‐22 sleep domain scores improved from 13.7 ± 6.8 to 7.7 ± 6.6 ( p 〈 0.001). Significant mean relative improvements were reported for “difficulty falling asleep” (45%; p 〈 0.001), “waking up at night” (40%; p 〈 0.001), “lack of a good night's sleep” (43%; p 〈 0.001), “waking up tired” (40%; p 〈 0.001), and “fatigue” (42%; p 〈 0.001) scores. A total of 66% of study participants reported postoperative improvement in “lack of a good night's sleep,” “waking up tired,” and “fatigue”; 62% reported improvement in “waking up at night”; and 58% reported improvement in “difficulty falling asleep.” Conclusion Patients with CRS report significant and sustained improvements following ESS in common sleep‐related symptoms as assessed by the SNOT‐22 sleep domain. Despite these significant improvements, some degree of persistent postoperative sleep impairment was reported. Further study is necessary to determine what factors are associated with continued sleep dysfunction after sinus surgery.
    Type of Medium: Online Resource
    ISSN: 2042-6976 , 2042-6984
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2604059-1
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  • 10
    Online Resource
    Online Resource
    Elsevier BV ; 2015
    In:  International Journal of Pediatric Otorhinolaryngology Vol. 79, No. 10 ( 2015-10), p. 1778-1781
    In: International Journal of Pediatric Otorhinolaryngology, Elsevier BV, Vol. 79, No. 10 ( 2015-10), p. 1778-1781
    Type of Medium: Online Resource
    ISSN: 0165-5876
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2015
    detail.hit.zdb_id: 2224872-9
    detail.hit.zdb_id: 2009657-4
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