Ed Kuan, MD, calls publication ‘one-stop shop’ for sinonasal tumors
UCI Health rhinologist Ed Kuan, MD, MBA, has taken the lead in publishing an International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) in the International Forum of Allergy & Rhinology.
The ICSNT document consists of four major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology-based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention.
Hi, everybody. My name is Edward Kwon. I'm a otolaryngologist at University of California Irvine. Uh My focus area is Rhinology and skull base surgery which focuses on disorders of the nose sinuses and skull base. My focus area in academics is in the area of Seon, nasal tumors and skull base surgery and reconstruction. The International Consensus Statement on allergy and rhinology, Cyon nasal tumors or Iar Cyon nasal tumors or sometimes I CS and T for short is one of my major projects that I've been bleeding in the last couple of years. Uh It is a very important endeavor in our specialty mainly because there has been no evidence based one stop shop for clinicians to be able to reference any information on Cyan Na tumors which while leveraging the most up to date literature, it is a multidisciplinary international and collaborative document featuring more than 200 authors spanning specialties from rhinology, head and neck oncology, medical oncology, radiation oncology, pathology, and radiology among others. And it really is a tour de force in terms of being able to take a lot of different disciplines together to help benefit patients worldwide. The value of the I CS and T is to be able to provide a one stop shop for clinicians to be able to reference in order to better help their patients. It's important to emphasize that I CS and T is not guidelines. It really is a summation of the most updated evidence based work in this area so that uh clinicians can really look up a disease, look up a rare tumor and be able to see what the literature reflects on that specific topic. They can then apply that information to their own patients. Uh Because as we know that every patient is different and really be able to tailor a targeted treatment plan for them. The S and T is divided into four major thematic categories. The first is general principles related to oncology as it applies to cyan nasal tumors. It covers things like margin analysis, recept il management of the orbit radiation modalities and really provides an open review on a lot of these large controversial topics. The second part is on benign lesions and neoplasms which has a focus on inverted papillomas, juvenile nasopharyngeal angiofibroma among other commonly encountered benign tumors from the very common to the very rare. The third part is on malignant neoplasms, which is probably the meat of the entire document and it really talks about state of the art management principles related to most of these which are also commonly encountered in many oncology practices. The last part is focused on quality of life, surveillance and morbidity and talks about how to take care of patients after they've survived their cancer and long term, how to monitor them. I think these four different categories really have a important interplay with each other and can really help guide taking care of the patient as a whole. One of the most notable things when putting this document together, uh which by the way is a heavily multidisciplinary uh multi institutional and collaborative effort uh which cannot be just myself. It really is the effort of all 200 authors, particularly my editorial team um is that we have a lot to learn about Cyon nasal tumors as a whole. There's a lot of exciting research that needs to come out both on the basic science, the translation and also the clinical fronts. There is a section at the very end of the document that highlights a lot of these research opportunities and knowledge gaps, which really will promote further research into this area. And we are certainly one of the centers working on uh driving some of these areas forward in order to help benefit patients worldwide. And I hope that everyone who reads it gets the opportunity to also think of things in their own practice that can help patients going forward because sinonasal tumors are so rare. Currently, the quality of evidence is still very low. As you'll see throughout the document, there's a lot to be learned by collaborating with one another. One of the things as a surgeon is that when we learn from our oncology, colleagues, both medical and radiation oncologists, we realize that the level of evidence that they provide in their work is so much higher. So there's a lot of collaborative opportunities in order to drive the field forward when we work together. Um I always like to say that uh you know, when we work together, we travel further. And therefore, I do think the most important thing is being able to uh develop multidisciplinary paradigms to take care of patients, but also to drive research for it together. The I CS NT is a collaborative effort uh led by an editorial team. Uh As the primary editor, I really have to really thank my senior editor colleague, Dr Jim Palmer from the University of Pennsylvania, as well as the associate editor team, which is Dr Eric Wong from the University of Pittsburgh, Doctor Dan Beswick from UCL, a Doctor Marilyn Wong from UCL, a Doctor Nathan Adaa from Penn, Doctor Shirley Sue from MD Anderson, and Doctor Nile London from Johns Hopkins and the NIH. Without their collaboration and hard work, this project would not be possible.
