Abstract
Sinonasal malignancies are rare and survival analysis in affected patients is arduous and perplexing due to various factors. In this review article, attempt has been made to overcome some of those factors while analysing survival outcomes. Aims and objectives: The aim of this study was to share the experience of a tertiary care centre in the surgical management of sinonasal malignancies over 12 years. Materials and Methods: This study is a retrospective chart review, and in this study, hospital records of 58 patients with biopsy proven sinonasal malignancies were studied. Only the patients undergoing primary or salvage surgery at our institution from May-2000 to April-2012 with a minimum follow up of 2 years were included. Statistical analyses such as means, proportions, Kaplan–Meier analysis and Cox's regression model were done. Results: Majority of the patients were males (n = 43) belonging to fourth and fifth decades. Squamous cell carcinoma was the most common (n = 17) histopathological type, followed by adenoid cystic carcinoma (n = 14). Majority presented with stage IV disease (n = 42). 17 patients were operated for recurrent disease. Over all 5 year survival was 72 % and disease free survival was 44 %. Separate analysis for epithelial and matched non-epithelial group showed poorer prognosis with epithelial group (p = 0.0120). Multivariate analysis showed histopathological type (epithelial) and presence of pathological risk factors (positive margins and/or perineural invasion) affecting survival. Conclusions: Advanced stage presentation is the norm for sinonasal malignancies. This study noted a 5 year overall survival of 72 % and disease free survival of 44 %. Epithelial histopathology carries poorer prognosis then other counterparts and incomplete removal is shown to add to poor prognosis independently.
Similar content being viewed by others
References
Lango MN, Topham NS, Perlis CS, Flieder DB, Weaver MW, Turaka A et al (2010) Surgery in the multimodality treatment of sinonasal malignancies. Curr Probl Cancer 34:304–321
Resto VA, Deschler DG (2004) Sinonasal malignancies. Otolaryngol Clin North Am 37:473–487
Edge S, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (2010) Nasal cavity and paranasal sinuses. AJCC cancer staging manual, 7th ed. Springer, New York, pp 69–78
Kadish S, Goodman M, Wang CC (1976) Olfactory neuroblastoma. A clinical analysis of 17 cases. Cancer 37:1571–1576
Bridger MW, Beale FA, Bryce DP (1978) Carcinoma of the paranasal sinuses—a review of 158 cases. J Otolaryngol 7:379–388
Frazell EL, Lewis JS (1963) Cancer of the nasal cavity and accessory sinuses. A report of the management of 416 patients. Cancer 16:1293–1301
Carrau RL, Myers EN, Johnson JT (1992) Paranasal sinus carcinoma—diagnosis, treatment, and prognosis. Oncology 6:43–50
Weber AL (1988) Tumours of the paranasal sinuses. Otolaryngol Clin N Am 21:439–454
Lavertu P, Roberts JK, Kraus DH, Levine HL, Wood BG, Medendorp SV et al (1989) Squamous cell carcinoma of the paranasal sinuses: the Cleveland Clinic experience 1977–1986. Laryngoscope 99:1130–1136
Spiro JD, Soo KC, Spiro RH (1995) Non squamous cell malignant neoplasms of the nasal cavities and paranasal sinuses. Head Neck 17:114–118
Jakobsen MH, Larsen SK, Kirkegaard J, Hansen HS (1997) Cancer of the nasal cavity and paranasal sinuses. Prognosis and outcome of treatment. Acta Oncol 36:27–31
Resto VA, Chan AW, Deschler DG, Lin DT (2008) Extent of surgery in management of locally advanced sinonasal malignancies. Head Neck 30:222–229
Stammberger H, Posawetz W (1990) Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol 247:63–76
Batra PS, Citradi MJ, Worley S, Lee J, Lanza DC (2005) Resection of anterior skull base tumours comparison of combined traditional & endoscopic techniques. Am J Rhinol 19:521–528
Bogaerts S, Vander Poorten V, Nuyts S, Van den Bogaert W, Jorissen M (2008) Results of endoscopic resection followed by radiotherapy for primarily diagnosed adenocarcinomas of the paranasal sinuses. Head Neck 30:728–736
Arnold A, Ziglinas P, Ochs K, Alter N, Geretschläger A, Lädrach K et al (2012) Therapy options and long-term results of sinonasal malignancies. Oral Oncol 48:1031–1037
Lupinetti AD, Roberts DB, Williams MD, Kupferman ME, Rosenthal DI, Demonte F et al (2007) Sinonasal adenoid cystic carcinoma: the M. D. Anderson Cancer Centre experience. Cancer 110:2726–2731
Garden AS, Weber RS, Ang KK, Morrison WH, Matre J, Peters LJ (1994) Postoperative radiation therapy for malignant tumours of minor salivary glands. Outcome and patterns of failure. Cancer 73:2563–2569
St-Pierre S, Baker SR (1983) Squamous cell carcinoma of the maxillary sinus: analysis of 66 cases. Head Neck Surg 5:508–513
Madison Michael L II, Sorenson JM, Samant S, Robertson JH (2005) The treatment of advanced sinonasal malignancies with pre-operative intra-arterial cisplatin and concurrent radiation. J Neurooncol 72:67–75
Jakobsen MH, Larsen SK, Kirkegaard J, Hansen HS (1997) Cancer of the nasal cavity and paranasal sinuses. Prognosis and outcome of treatment. Acta Oncol 36:27–31
Carrau RL, Segas J, Nuss DW, Snyderman CH, Janecka IP, Myers EN et al (1999) Squamous cell carcinoma of the sinonasal tract invading the orbit. Laryngoscope 109:230–235
McNicoll W, Hopkin N, Dalley VM, Shaw HJ (1984) Cancer of the paranasal sinuses and nasal cavities. Part II. Results of treatment. J Laryngol Otol 98:707–718
Spiro RH, Thaler HT, Hicks WF, Kher UA, Huvos AH, Strong EW (1991) The importance of clinical staging of minor salivary gland carcinoma. Am J Surg 162:330–336
Day TA, Beas RA, Schlosser RJ, Woodworth BA, Barredo J, Sharma AK et al (2005) Management of paranasal sinus malignancy. Curr Treat Options Oncol 6:3–18
Acknowledgements
The authors wish to thank Dr. Nikhil S V, MD. (Preventive and Social Medicine), for Statistical analysis and Dr Vinay Kumar, MD (Radiotherapy) for support in data retrieval.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Devaraja, K., Sikka, K., Kumar, R. et al. Sinonasal Malignancies: Long Term Follow Up After Surgical Management—An Analysis of Outcomes. Indian J Otolaryngol Head Neck Surg 67, 28–33 (2015). https://doi.org/10.1007/s12070-014-0742-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-014-0742-2