Single modality and multimodality treatment of nasal and paranasal sinuses cancer: a single institution experience of 229 patients

Eur J Surg Oncol. 2007 Mar;33(2):222-8. doi: 10.1016/j.ejso.2006.10.033. Epub 2006 Nov 28.

Abstract

Aims: To assess the single and multimodal treatment results and prognostic factors for sinonasal carcinoma.

Methods: Overall survival (OS), disease-specific survival (DSS), local control (LC), and disease-free survival (DFS) in 229 patients with sinonasal carcinoma treated from 1967 to 2003 were calculated. Prognostic factors were univariately and multivariately analyzed. The median follow-up period for survivors was 126 months.

Results: 32% of the patients were operated only, 47% underwent multimodal therapy, and 20% were treated without operation. The 5-year OS rate was 41%, and the DSS rate was 51%. The LC rate was 64%, and the DFS rate was 34%. Prognostic for DSS were M status (p<0.001), UICC stage (p<0.001), T classification (p=0.001), N status (p=0.002), intracranial tumor infiltration (p=0.008), infiltration of the pterygopalatine fossa (p=0.02), infiltration of the skull base (p=0.021), infiltration of the orbita (p=0.041), and the type of therapy (p<0.001): The 5-year DSS rate was 63% for patients operated only, 56% for all operated patients, 46% for patients undergoing surgery and radiotherapy, but only 21% for patients treated with radiotherapy+/-chemotherapy. Multivariate analysis revealed that T classification (p=0.042), N classification (p=0.035), M classification (p=0.007), UICC stage (p=0.038), and type of therapy (p=0.038) were independent prognostic factors for DSS.

Conclusions: Radical surgery is recommended for stage I/II sinonasal carcinomas. Stage III/IV carcinomas still have a poor prognosis, but multimodal treatment seems to favor the outcome.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Nose Neoplasms / diagnosis
  • Nose Neoplasms / mortality
  • Nose Neoplasms / therapy*
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Paranasal Sinus Neoplasms / diagnosis
  • Paranasal Sinus Neoplasms / mortality
  • Paranasal Sinus Neoplasms / therapy*
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Survival Rate / trends
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antineoplastic Agents