Skip to main content

Advertisement

SpringerLink
Log in

Choice of surgery in intestinal-type adenocarcinoma of the sinonasal tract: a long-term comparative study

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Intestinal-type adenocarcinoma (ITAC) is a rare sinonasal malignancy. Curative treatment requires multidisciplinary approach, with surgical options consist of the endonasal endoscopic approach (EEA) and external surgery (EXTS). Here, we provide the post-operative and survival results from a single-center long-term follow-up.

Methods

We report long-term follow-up of 92 ITAC cases treated between 1998 and 2018, treated with EEA (n = 40) or EXTS (n = 52). Survival estimates, post-operative complications and duration of hospitalization were compared between surgical modalities.

Results

Baseline characteristics were similar. A higher number of T4b tumors (16%), and subsequently more tumoral invasion (39%), was present in patients undergoing EXTS compared to EEA (3% and 18%, respectively). No difference in Barnes histology subtypes was noticed. Patients undergoing EEA had a shorter post-operative hospitalization stay versus EXTS (4 versus 7 days). Use of EEA was associated to improved disease-specific survival (DSS; 11.4 versus 4.4 years; HREEA = 0.53), especially for patients with T3–4a tumors (11.4 versus 3.0 years; HREEA = 0.41). Patients with T3–4 stage, tumoral invasion, positive surgical margins, mucinous or mixed histology, and prolonged post-operative hospital stay showed poor local relapse-free, disease-free, overall, and DSS.

Conclusions

Long-term follow-up in locally advanced ITAC demonstrates that resection by EEA is correlated with improved DSS compared to EXTS, especially for T3–4 tumors. No significant differences between both treatment modalities was observed regarding per- and post-operative complications, although hospitalization in patients undergoing EEA was shorter than for patients treated with EXTS. These results confirm that EEA should remain the preferred surgical procedure in operable cases of sinonasal ITAC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

All data generated and analyzed during this study cannot be shared publicly due to the European General Data Protection Regulation (EU GDPR). The data will be shared on reasonable request to the corresponding author, following approval of the data protection officer of the University Hospital Ghent.

References

  1. Sklar EM, Pizarro JA (2003) Sinonasal intestinal-type adenocarcinoma involvement of the paranasal sinuses. AJNR Am J Neuroradiol 24:1152–1155

    PubMed  PubMed Central  Google Scholar 

  2. Gallet P, Nguyen DT, Russel A, Jankowski R, Vigouroux C, Rumeau C (2018) Intestinal and non-intestinal nasal cavity adenocarcinoma: impact of wood dust exposure. Eur Ann Otorhinolaryngol Head Neck Dis 135:383–387. https://doi.org/10.1016/j.anorl.2018.08.012

    Article  CAS  PubMed  Google Scholar 

  3. Leivo I (2017) Intestinal-type adenocarcinoma: classification, immunophenotype, molecular features and differential diagnosis. Head Neck Pathol 11:295–300. https://doi.org/10.1007/s12105-017-0800-7

    Article  PubMed  PubMed Central  Google Scholar 

  4. Georgel T, Jankowski R, Henrot P, Baumann C, Kacha S, Grignon B, Toussaint B, Graff P, Kaminsky MC, Geoffrois L, Vignaud JM (2009) CT assessment of woodworkers’ nasal adenocarcinomas confirms the origin in the olfactory cleft. AJNR Am J Neuroradiol 30:1440–1444. https://doi.org/10.3174/ajnr.A1648

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Jankowski R, Georgel T, Vignaud JM, Hemmaoui B, Toussaint B, Graff P, Geoffrois L, Henrot P, Kaminsky MC (2007) Endoscopic surgery reveals that woodworkers’ adenocarcinomas originate in the olfactory cleft. Rhinology 45:308–314

    CAS  PubMed  Google Scholar 

  6. Choussy O, Ferron C, Vedrine PO, Toussaint B, Lietin B, Marandas P, Babin E, De Raucourt D, Reyt E, Cosmidis A, Makeieff M, Dehesdin D (2010) Role of radiotherapy in the treatment of nasoethmoidal adenocarcinoma. Arch Otolaryngol Head Neck Surg 136:143–146. https://doi.org/10.1001/archoto.2009.212

    Article  PubMed  Google Scholar 

  7. Rampinelli V, Ferrari M, Nicolai P (2018) Intestinal-type adenocarcinoma of the sinonasal tract: an update. Curr Opin Otolaryngol Head Neck Surg 26:115–121. https://doi.org/10.1097/MOO.0000000000000445

    Article  PubMed  Google Scholar 

  8. Kennedy MT, Jordan RC, Berean KW, Perez-Ordonez B (2004) Expression pattern of CK7, CK20, CDX-2, and villin in intestinal-type sinonasal adenocarcinoma. J Clin Pathol 57:932–937. https://doi.org/10.1136/jcp.2004.016964

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kim J, Chang H, Jeong EC (2018) Sinonasal intestinal-type adenocarcinoma in the frontal sinus. Arch Craniofac Surg 19:210–213. https://doi.org/10.7181/acfs.2018.01970

    Article  PubMed  PubMed Central  Google Scholar 

  10. Vergez S, du Mayne MD, Coste A, Gallet P, Jankowski R, Dufour X, Righini C, Reyt E, Choussy O, Serrano E, Crampette L, Debry C, de Gabory L (2014) Multicenter study to assess endoscopic resection of 159 sinonasal adenocarcinomas. Ann Surg Oncol 21:1384–1390. https://doi.org/10.1245/s10434-013-3385-8

    Article  PubMed  Google Scholar 

  11. Vergez S, Martin-Dupont N, Lepage B, De Bonnecaze G, Decotte A, Serrano E (2012) Endoscopic vs transfacial resection of sinonasal adenocarcinomas. Otolaryngol Head Neck Surg 146:848–853. https://doi.org/10.1177/0194599811434903

    Article  PubMed  Google Scholar 

  12. Weber RK, Hosemann W (2015) Comprehensive review on endonasal endoscopic sinus surgery. GMS Curr Top Otorhinolaryngol Head Neck Surg 14:Doc08. https://doi.org/10.3205/cto000123

    Article  PubMed  PubMed Central  Google Scholar 

  13. Suh JD, Ramakrishnan VR, Chi JJ, Palmer JN, Chiu AG (2013) Outcomes and complications of endoscopic approaches for malignancies of the paranasal sinuses and anterior skull base. Ann Otol Rhinol Laryngol 122:54–59. https://doi.org/10.1177/000348941312200110

    Article  PubMed  Google Scholar 

  14. Barnes L (1986) Intestinal-type adenocarcinoma of the nasal cavity and paranasal sinuses. Am J Surg Pathol 10:192–202. https://doi.org/10.1097/00000478-198603000-00006

    Article  CAS  PubMed  Google Scholar 

  15. Castelnuovo P, Turri-Zanoni M, Battaglia P, Antognoni P, Bossi P, Locatelli D (2016) Sinonasal malignancies of anterior skull base: histology-driven treatment strategies. Otolaryngol Clin N Am 49:183–200. https://doi.org/10.1016/j.otc.2015.09.012

    Article  Google Scholar 

  16. Duprez F, Madani I, Morbee L, Bonte K, Deron P, Domjan V, Boterberg T, De Gersem W, De Neve W (2012) IMRT for sinonasal tumors minimizes severe late ocular toxicity and preserves disease control and survival. Int J Radiat Oncol Biol Phys 83:252–259. https://doi.org/10.1016/j.ijrobp.2011.06.1977

    Article  PubMed  Google Scholar 

  17. Castelnuovo P, Lambertoni A, Sileo G, Valentini M, Karligkiotis A, Battaglia P, Turri-Zanoni M (2021) Critical review of multidisciplinary approaches for managing sinonasal tumors with orbital involvement. Acta Otorhinolaryngol Ital 41:S76–S89. https://doi.org/10.14639/0392-100X-suppl.1-41-2021-08

    Article  PubMed  PubMed Central  Google Scholar 

  18. Kawaguchi M, Kato H, Tomita H, Mizuta K, Aoki M, Hara A, Matsuo M (2017) Imaging characteristics of malignant sinonasal tumors. J Clin Med 5:5. https://doi.org/10.3390/jcm6120116

    Article  Google Scholar 

  19. Chatelet F, Simon F, Bedarida V, Le Clerc N, Adle-Biassette H, Manivet P, Herman P, Verillaud B (2021) Surgical management of sinonasal cancers: a comprehensive review. Cancers. https://doi.org/10.3390/cancers13163995

    Article  PubMed  PubMed Central  Google Scholar 

  20. Cracchiolo JR, Patel K, Migliacci JC, Morris LT, Ganly I, Roman BR, McBride SM, Tabar VS, Cohen MA (2018) Factors associated with a primary surgical approach for sinonasal squamous cell carcinoma. J Surg Oncol 117:756–764. https://doi.org/10.1002/jso.24923

    Article  PubMed  Google Scholar 

  21. Debacker J, Huvenne W, Bonte K, De Neve W, Deron P, Ost P, Van Zele T, Vermeersch H, Duprez F (2018) Open surgery versus primary radiotherapy in T4b sinonasal carcinoma. B-ENT 14:93–99

    Google Scholar 

  22. Lund VJ, Clarke PM, Swift AC, McGarry GW, Kerawala C, Carnell D (2016) Nose and paranasal sinus tumours: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 130:S111–S118. https://doi.org/10.1017/S0022215116000530

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Ganly I, Patel SG, Singh B, Kraus DH, Bridger PG, Cantu G, Cheesman A, De Sa G, Donald P, Fliss D, Gullane P, Janecka I, Kamata SE, Kowalski LP, Levine P, Medina LR, Pradhan S, Schramm V, Snyderman C, Wei WI, Shah JP (2005) Complications of craniofacial resection for malignant tumors of the skull base: report of an International Collaborative Study. Head Neck 27:445–451. https://doi.org/10.1002/hed.20166

    Article  PubMed  Google Scholar 

  24. Ganly I, Patel SG, Singh B, Kraus DH, Bridger PG, Cantu G, Cheesman A, De Sa G, Donald P, Fliss DM, Gullane P, Janecka I, Kamata SE, Kowalski LP, Levine PA, Medina Dos Santos LR, Pradhan S, Schramm V, Snyderman C, Wei WI, Shah JP (2005) Craniofacial resection for malignant paranasal sinus tumors: report of an international collaborative study. Head Neck 27:575–584. https://doi.org/10.1002/hed.20165

    Article  PubMed  Google Scholar 

  25. Kasemsiri P, Prevedello DM, Otto BA, Old M, Ditzel Filho L, Kassam AB, Carrau RL (2013) Endoscopic endonasal technique: treatment of paranasal and anterior skull base malignancies. Braz J Otorhinolaryngol 79:760–779. https://doi.org/10.5935/1808-8694.20130138

    Article  PubMed  Google Scholar 

  26. Verillaud B, Bresson D, Sauvaget E, Mandonnet E, Georges B, Kania R, Herman P (2012) Endoscopic endonasal skull base surgery. Eur Ann Otorhinolaryngol Head Neck Dis 129:190–196. https://doi.org/10.1016/j.anorl.2011.09.004

    Article  CAS  PubMed  Google Scholar 

  27. Alshammari DM, Almomen A, Taha M, Albahrna H, Alshammari S (2021) Quality of life and morbidity after endoscopic endonasal skull base surgeries using the sinonasal outcomes test (SNOT): a tertiary hospital experience. Int J Otolaryngol 2021:6659221. https://doi.org/10.1155/2021/6659221

    Article  PubMed  PubMed Central  Google Scholar 

  28. Nicolai P, Battaglia P, Bignami M, Bolzoni Villaret A, Delu G, Khrais T, Lombardi D, Castelnuovo P (2008) Endoscopic surgery for malignant tumors of the sinonasal tract and adjacent skull base: a 10-year experience. Am J Rhinol 22:308–316. https://doi.org/10.2500/ajr.2008.22.3170

    Article  PubMed  Google Scholar 

  29. Van Gerven L, Jorissen M, Nuyts S, Hermans R, Vander Poorten V (2011) Long-term follow-up of 44 patients with adenocarcinoma of the nasal cavity and sinuses primarily treated with endoscopic resection followed by radiotherapy. Head Neck 33:898–904. https://doi.org/10.1002/hed.21556

    Article  PubMed  Google Scholar 

  30. Meerwein CM, Brada MD, Soyka MB, Holzmann D, Rupp NJ (2022) Reappraisal of grading in intestinal-type sinonasal adenocarcinoma: tumor budding as an independent prognostic parameter. Head Neck Pathol. https://doi.org/10.1007/s12105-022-01410-3

    Article  PubMed  PubMed Central  Google Scholar 

  31. Meccariello G, Deganello A, Choussy O, Gallo O, Vitali D, De Raucourt D, Georgalas C (2016) Endoscopic nasal versus open approach for the management of sinonasal adenocarcinoma: a pooled-analysis of 1826 patients. Head Neck 38(Suppl 1):E2267-2274. https://doi.org/10.1002/hed.24182

    Article  PubMed  Google Scholar 

  32. Van Gerven L, Vander Poorten V, Jorissen M (2011) Adenocarcinomas of the sinonasal tract: current opinion. B-ENT 7(Suppl 17):15–20

    PubMed  Google Scholar 

  33. Franchi A, Miligi L, Palomba A, Giovannetti L, Santucci M (2011) Sinonasal carcinomas: recent advances in molecular and phenotypic characterization and their clinical implications. Crit Rev Oncol Hematol 79:265–277. https://doi.org/10.1016/j.critrevonc.2010.08.002

    Article  PubMed  Google Scholar 

  34. Llorente JL, Lopez F, Suarez C, Hermsen MA (2014) Sinonasal carcinoma: clinical, pathological, genetic and therapeutic advances. Nat Rev Clin Oncol 11:460–472. https://doi.org/10.1038/nrclinonc.2014.97

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Tijl Vermassen and Stijn De Keukeleire have contributed equally to this paper and have both designated as first author.

Authors and Affiliations

  1. Department Medical Oncology, University Hospital Ghent, Corneel Heymanslaan 10, Ghent, Belgium

    Tijl Vermassen, Michael Saerens, Sylvester Heerwegh & Sylvie Rottey

  2. Biomarkers in Cancer, Ghent University, Ghent, Belgium

    Tijl Vermassen, Michael Saerens & Sylvie Rottey

  3. Cancer Research Institute Ghent, Ghent, Belgium

    Tijl Vermassen, Michael Saerens, Jens M. Debacker, Wouter Huvenne, David Creytens, Sylvie Rottey & Fréderic Duprez

  4. Department Internal Medicine, University Hospital Brussels, Brussels, Belgium

    Stijn De Keukeleire

  5. Laboratory for Molecular Imaging and Therapy, Vrije Universiteit Brussel, Brussels, Belgium

    Jens M. Debacker

  6. Department Head and Neck Surgery, University Hospital Ghent, Ghent, Belgium

    Jens M. Debacker, Wouter Huvenne & Philippe Deron

  7. Upper Airway Research Laboratory, Ghent University, Ghent, Belgium

    Wouter Huvenne, Claus Bachert & Thibaut Van Zele

  8. Department Pathology, University Hospital Ghent, Ghent, Belgium

    David Creytens & Liesbeth Ferdinande

  9. Department Diagnostic Sciences, Ghent University, Ghent, Belgium

    David Creytens & Liesbeth Ferdinande

  10. Department Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium

    Claus Bachert & Thibaut Van Zele

  11. Department Radiation Oncology, University Hospital Ghent, Ghent, Belgium

    Fréderic Duprez

  12. Department Human Structure and Repair, Ghent University, Ghent, Belgium

    Fréderic Duprez

Authors
  1. Tijl Vermassen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stijn De Keukeleire
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael Saerens
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sylvester Heerwegh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jens M. Debacker
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Wouter Huvenne
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Philippe Deron
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. David Creytens
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Liesbeth Ferdinande
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Sylvie Rottey
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Claus Bachert
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Fréderic Duprez
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Thibaut Van Zele
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: TZ; methodology: TZ, FD; investigation and data accumulation: TV, SK, MS, WH, PD, SR, CB, FD, TZ; formal analysis: TV, SK, MS, SH, JD, DC, LF; writing–original draft preparation: TV, SK; writing–review and editing: all authors; resources: TZ, CB; supervision: TZ, CB.

Corresponding author

Correspondence to Tijl Vermassen.

Ethics declarations

Conflict of interest

The authors have no competing interests to declare that are relevant to the content of this article. No funding was acquired for this research.

Research involving human participants and/or animals

This research study was conducted retrospectively from data obtained for clinical purposes. in the period 1998 – 2018. The study was approved by the local Ethics Committee of the University Hospital Ghent (Belgian registration number: B670201938932).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 231 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vermassen, T., De Keukeleire, S., Saerens, M. et al. Choice of surgery in intestinal-type adenocarcinoma of the sinonasal tract: a long-term comparative study. Eur Arch Otorhinolaryngol 281, 2993–3004 (2024). https://doi.org/10.1007/s00405-024-08447-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-024-08447-w

Keywords

Search

Navigation