{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T05:23:52Z","timestamp":1773552232316,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T00:00:00Z","timestamp":1560384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["CA060397"],"award-info":[{"award-number":["CA060397"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine factors affecting outcomes for patients with sinonasal and nasopharyngeal adenoid cystic carcinoma (SNACC) treated using the endoscopic endonasal approach (EEA) with preservation of key structures followed by adjuvant radiotherapy (RT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Retrospective case series of 30 patients treated at the University of Pittsburgh between 2000 and 2014. Hospital records were reviewed for clinical and pathologic data. Outcome measures included overall survival (OS), disease\u2010free survival (DFS), local recurrence\u2010free survival (LRFS) and distant metastasis\u2010free survival (DMFS) rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority of patients had T4a and T4b disease (23.3%, and 63.3%). Microscopically positive margins were present in 21 patients (63.6%). Positive margins were present in nine patients (30.0%). The mean and median follow\u2010up were 3.97 and 3.29 years. Five\u2010year OS, DFS, LRFS, and DMFS were 62.66%, 58.45%, 87.54%, and 65.26%. High\u2010\/intermediate\u2010grade tumors had worse DFS (<jats:italic>P<\/jats:italic> = .023), and LRFS (<jats:italic>P<\/jats:italic> = .026) (HR = 4.837, 95% CI, 1.181\u201319.812). No factors were associated with significantly worse DMFS. No patient suffered CSF leak, optic nerve, or internal carotid injury. The mean and median length of hospital stay was 4.1 days and 2.0 days (range: 0\u201332 days).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Organ\u2010preserving EEA with adjuvant RT for low\u2010grade SNACC offers 5\u2010year survival similar to that reported by other studies, which include radical, open skull base surgery. Patients with high\u2010grade disease do poorly and may benefit from novel treatment strategies. For low\u2010grade disease, organ\u2010preserving EEA with RT may be the best option, offering a balance of survival, quality of life, and decreased morbidity for patients with this difficult\u2010to\u2010cure disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:bold><jats:italic>Laryngoscope, 130:1414\u20131421, 2020<\/jats:italic><\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28100","type":"journal-article","created":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T13:11:29Z","timestamp":1560431489000},"page":"1414-1421","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The endoscopic endonasal approach for sinonasal and nasopharyngeal adenoid cystic carcinoma"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4569-1223","authenticated-orcid":false,"given":"Ryota","family":"Kashiwazaki","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8621-6168","authenticated-orcid":false,"given":"Meghan T.","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery West Virginia University  Morgantown West Virginia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathew","family":"Geltzeiler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Oregon Health Sciences University  Portland Oregon U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan C.","family":"Fernandez\u2010Miranda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Stanford University  Palo Alto California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Stanford University  Palo Alto California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl H.","family":"Snyderman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania U.S.A."},{"name":"Department of Neurologic Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric W.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,6,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(74)90265-7"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(95)00122-F"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21830"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-013-0487-3"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(79)90423-9"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2008.525"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1058137"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0709(99)90028-5"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215113000480"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0347(199908)21:5<402::AID-HED4>3.0.CO;2-Z"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000216900.03188.48"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1347358"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10380"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(97)00153-0"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10126"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.1.JNS142462"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1974.00780040087001"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23096"},{"key":"e_1_2_7_20_1","first-page":"828","article-title":"Conservation surgery in the management of adenoidcystic carcinoma of the head and neck","volume":"62","author":"Harrison DF","year":"1986","journal-title":"Bull N Y Acad Med"},{"key":"e_1_2_7_21_1","unstructured":"Network NCC. 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