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Maligne Erkrankungen des Sinunasaltrakts

Eine monoinstitutionelle Erfahrung von 1996 bis 2010

Sinonasal tract malignancies

A 14-year single institution experience

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Zusammenfassung

Hintergrund

Maligne sinunasale Tumoren sind mit einer jährlichen Inzidenz von weltweit 1/200.000 selten.

Material und Methoden

Es wurden retrospektiv alle Patienten erfasst (n = 177), welche im Zeitraum 1996–2010 an der HNO-Universitätsklinik Bonn aufgrund sinunasaler Malignome therapiert wurden. Inzidenz, Alter und Geschlecht waren für alle Entitäten vorhanden. Weitere demographische Daten, Therapie und Follow-up wurden ausschließlich für Karzinome analysiert.

Ergebnisse

Die häufigste Entität war das Karzinom (58%). Unspezifische Beschwerden vor Erstdiagnose dauerten 4,7 ± 5 Monate an. Obwohl 64% der Karzinompatienten ein lokal fortgeschrittenes Tumorleiden (T3–4) aufwiesen, zeigten nur 15% lokoregionäre Lymphknotenmetastasen. Die Gesamt-3-Jahres-Überlebenswahrscheinlichkeit lag bei 61%. Patienten mit ausschließlich operativer Therapie hatten eine deutlich bessere Prognose als Patienten nach kombinierter oder primärer Radio(chemo)therapie. Das T-Stadium konnte als unabhängiger prognostischer Faktor identifiziert werden.

Schlussfolgerung

Aufgrund unspezifischer Beschwerdesymtomatik werden sinunasale Malignome meist erst in fortgeschrittenem Tumorstadium diagnostiziert. Trotz multimodaler Therapieansätze ist die Prognose schlecht.

Abstract

Background

With a worldwide annual incident rate of 1/200,000 sinonasal tract malignancies are a relatively rare disease.

Material and methods

All patients with sinonasal malignancies (n = 177) treated between 1996 and 2010 at the Department of Head and Neck Surgery, University of Bonn, Germany were analyzed retrospectively. Data on age, gender and incidence were available for all patients but other demographic data, treatment regimes and outcome were only analyzed for carcinomas.

Results

Carcinomas were the most frequent histological diagnosis (58%). Unspecific sinonasal symptoms lasted on average for 4.7 ± 5 months before primary diagnosis. Interestingly, 64% of patients with sinonasal carcinoma presented with locally advanced disease (T3–4) but only 15% displayed corresponding regional lymph node metastases. The overall 3-year survival rate was 61%. Patients solely needing surgical treatment displayed a better survival rate than patients receiving combined surgery and adjuvant treatment or definitive radio(chemo)therapy. Multivariate analysis revealed a T-stage classification as the only independent prognostic factor for 3-year survival.

Conclusions

Due to unspecific symptoms most sinonasal malignancies are diagnosed at an advanced stage of the disease and despite multimodal therapies these tumors still have an unfavorable prognosis.

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Authors and Affiliations

  1. Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde/-Chirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland

    A. Schröck, T. van Bremen, M. Jakob, T. Ehrenberg, M. Kühnemund, A. Gerstner & K.W.G. Eichhorn

  2. Klinik für Pathologie, Universität Bonn, Bonn, Deutschland

    F. Göke & R. Kirsten

Authors
  1. A. Schröck
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  2. F. Göke
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  3. T. van Bremen
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  4. R. Kirsten
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  5. M. Jakob
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  6. T. Ehrenberg
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  7. M. Kühnemund
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  8. A. Gerstner
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  9. K.W.G. Eichhorn
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Corresponding author

Correspondence to A. Schröck.

Additional information

Schröck A und Göke F teilen die Erstautorenschaft.

Dieser Beitrag ist Prof. Dr. med. Dr. h.c. Friedrich Bootz zum 60. Geburtstag gewidmet.

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Schröck, A., Göke, F., van Bremen, T. et al. Maligne Erkrankungen des Sinunasaltrakts. HNO 60, 1041–1046 (2012). https://doi.org/10.1007/s00106-012-2577-z

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  • DOI: https://doi.org/10.1007/s00106-012-2577-z

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