Results of orbital preservation for advanced malignant maxillary sinus tumors.
OBJECTIVE
The purpose of the study was to examine the oncological and functional outcomes of multimodality therapy for patients with advanced malignant maxillary sinus tumors that invaded the orbit.


METHODS
Retrospective study.


METHODS
The medical records of 26 patients with orbital invasion were retrospectively analyzed. The patient group consisted of 16 men and 10 women, with a median age of 58 years. The mean follow-up period was 73 months. The most common disease was squamous cell carcinoma. Seven patients had nodal disease. All patients underwent simultaneous combined therapy consisting of conservative surgery through a sublabial incision, radiotherapy, and regional chemotherapy. Patients with nodal disease were treated with either irradiation or selective neck dissection.


RESULTS
The 5- and 10-year overall survival rates were 68% and 51%, respectively. The 5- and 10-year local control rates were 66% and 51%, respectively. Overall survival rates and local control rates were significantly worse in patients with disease other than squamous cell carcinoma. Local control rates were significantly worse in patients with orbital apex disease than in patients without orbital apex disease. All 26 patients, despite orbital involvement, retained their orbital contents. Nineteen of these patients demonstrated adequate ocular function.


CONCLUSIONS
Combined therapy with conservative surgery, radiotherapy, and regional chemotherapy is an effective method for local control and preservation of ocular function. However, performing orbital conservation procedure in patients with disease other than squamous cell carcinoma and with orbital apex disease must be considered carefully.
Nishino
Hiroshi
H
Department of Otolaryngology-Head and Neck Surgery, Jichi Medical School, Kawachi-gun, Tochigi, Japan. hiroshi@jichi.ac.jp
Ichimura
Keiichi
K
Tanaka
Hidetaka
H
Ishikawa
Kazuhiro
K
Abe
Kouichi
K
Fujisawa
Yoshiro
Y
Shinozaki
Takeshi
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009918:Orbital Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate