The role of skull base surgery for the treatment of adenoid cystic carcinoma of the sinonasal tract

PubMedID: 10402519Background. Adenoid cystic carcinoma (ACC) of the sinonasal tract is an aggressive malignancy associated with a poor 5-year survival rate. The role of skull base surgery for the treatment of patients presenting with sinonasal ACC and its impact upon their survival has not previously been evaluated. Methods. A retrospective review of 35 patients with ACC of the sinonasal tract who were treated with surgery and radiation therapy at the University of Pittsburgh Medical Center was performed to evaluate patient outcome. Results. Local recurrence of tumor following surgery and radiation therapy was observed in 36% of the patients originally treated at the University of Pittsburgh Medical Center. Fourteen percent of these patients developed a regional tumor recurrence, and 21% developed distant metastases. We did not identify any tumor-related factors that predicted patient outcome. Local recurrences were treated with salvage surgical excision, and, despite aggressive management, only 1 of 17 patients with local recurrence was considered cured (NED) at 24 months (follow-up after salvage surgery). Overall, disease-free survival was 46.4%, at a median follow-up of 40 months. Conclusions. ACC of the sinonasal tract is an aggressive malignancy. Skull base surgery has facilitated the gross total excision of advanced lesions that were deemed inoperable in the past, but has not resulted in an overall improvement in disease-free survival. Local recurrence portends a very poor prognosis, despite aggressive salvage regimens. Alternative therapies for local recurrences warrant further investigation. Prospective, randomized studies are necessary to evaluate the outcome of patients treated with aggressive multimodal treatment regimens, including chemotherapeutic regimens

Benchmark evaluation of a single frequency continuous wave OPO seeded pulsed dye amplifier for high-resolution laser spectroscopy

International audienceThe study of the atomic spectrum via resonant laser excitation provides access to underlying effects caused by the nuclear structure, which is of special interest in short-lived radioisotopes produced at Isotope Separator On-Line (ISOL) facilities. Current implementations of resonant laser ionization techniques often limit the extraction of the nuclear observables due to the low spectral resolution of the pulsed laser systems deployed. Several high-resolution spectroscopy techniques demand spectral widths in the order of hundreds of MHz and below. A proven solution to reduce this linewidth is the pulsed amplification of a narrow-band continuous wave (cw) laser. This work presents the demonstration of a pulsed dye amplifier seeded by a commercially available cw Optical Parametric Oscillator (OPO). The performance of this system was compared with competing setups using a cw dye laser seed source as well as a frequency mixing technique using a combination of an injection-locked titanium:sapphire (Ti:Sa) and a Nd:YVO4 laser. Spectral bandwidths of the systems were measured using a high finesse Fabry-Perot Interferometer, resulting in comparable optical linewidths between 140 to 156 MHz at a wavelength of 328 nm for the different laser setups. Suitability for on-line experiments was validated by performing high-resolution spectroscopy of radioactive silver isotopes in the Collinear Resonance Ionization Spectroscopy (CRIS) experiment at the Isotope Separator On-Line Device (ISOLDE), at the European Organization for Nuclear Research (CERN). The quality of the hyperfine spectra was similar for the dye and the OPO seed and the deduced hyperfine splitting was in good agreement with literature, while the frequency mixing technique exhibited less precise results attributed to the frequency instabilities and mode-hops of the single-mode Nd:YVO4 laser

Proposal for A Rational Classification of Neck Dissections

status: publishe