Background: To investigate the prognostic significance of paranasal sinus invasion in nasopharyngeal carcinoma (NPC) patients.
Methods: Patients with NPC after intensity-modulated radiotherapy from 2010 to 2013 were identified (n = 1225). Clinical features and magnetic resonance images were analyzed.
Results: Paranasal sinus invasion was identified in 182/1225 patients (14.9%). Multivariate analysis showed that paranasal sinus invasion was an independent factor for overall survival, progression-free survival, distant metastasis-free survival, and local recurrence-free survival (P < .05 for all). T3 NPC patients with paranasal sinus invasion had a poorer prognosis than those without (P < .05), and there was no significant survival difference compared with T4 patients, regardless of involvement of inner structures (P > .05 for all). Upgrading NPC with paranasal sinus invasion to T4 disease achieved better predictive abilities.
Conclusions: Paranasal sinus invasion is an independent prognostic factor for NPC. It may be appropriate to upgrade the T classification.
Keywords: intensity-modulated radiotherapy; nasopharyngeal carcinoma; paranasal sinus; prognosis; staging system.
© 2019 Wiley Periodicals, Inc.