Paranasal sinus tumors: Peter MacCallum Cancer Institute experience.
BACKGROUND
The purpose of this study was to evaluate the local control, pattern of recurrence, overall survival, and prognostic factors of patients with squamous cell carcinoma (SCC), adenocarcinoma, and undifferentiated carcinoma of the paranasal sinuses (PNS) and nasal cavity (NC) presenting to our center for curative treatment over a 10-year period.


METHODS
Between 1991 and 2000, 60 patients with SCC (n = 32), adenocarcinoma (n = 25), and undifferentiated carcinoma (n = 3) of the PNS or NC were identified. Forty patients received surgery and postoperative radiotherapy, four surgery alone; 11, radiotherapy alone; three radical radiotherapy after surgical recurrence; one, chemoradiotherapy and surgery; and one, induction chemotherapy followed by radiotherapy.


RESULTS
Forty-seven patients (78%) were seen with T3-4 disease; however, most (92%) were node negative on initial assessment. The predominant failure pattern was local disease persistence or recurrence. The estimated 2- and 5-year local control rates were 63% and 49%, respectively. Orbital and neural invasion significantly affected local control. The estimated 2- and 5 year overall survival rates were 57% and 40%, respectively.


CONCLUSIONS
Local failure remains the dominant cause for poor outcome in this group of patients. Because of the proximity of critical normal structures, the ability to perform adequate surgery and to deliver effective radiotherapy is limited in many cases. The use of postoperative concurrent chemoradiotherapy warrants further investigation.
Porceddu
Sandro
S
Peter MacCallum Cancer Institute, St Andrews Place, East Melbourne, Victoria 3002, Australia. Sandro.Porceddu@petermac.org
Martin
Jarad
J
Shanker
Gowrie
G
Weih
LeAnn
L
Russell
Christine
C
Rischin
Danny
D
Corry
June
J
Peters
Lester
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D001766:Blindness / Q000209:etiology; D002277:Carcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D009423:Nervous System Neoplasms / Q000556:secondary; D009669:Nose Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009918:Orbital Neoplasms / Q000556:secondary; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate