Single modality and multimodality treatment of nasal and paranasal sinuses cancer: a single institution experience of 229 patients.
OBJECTIVE
To assess the single and multimodal treatment results and prognostic factors for sinonasal carcinoma.


METHODS
Overall survival (OS), disease-specific survival (DSS), local control (LC), and disease-free survival (DFS) in 229 patients with sinonasal carcinoma treated from 1967 to 2003 were calculated. Prognostic factors were univariately and multivariately analyzed. The median follow-up period for survivors was 126 months.


RESULTS
32% of the patients were operated only, 47% underwent multimodal therapy, and 20% were treated without operation. The 5-year OS rate was 41%, and the DSS rate was 51%. The LC rate was 64%, and the DFS rate was 34%. Prognostic for DSS were M status (p<0.001), UICC stage (p<0.001), T classification (p=0.001), N status (p=0.002), intracranial tumor infiltration (p=0.008), infiltration of the pterygopalatine fossa (p=0.02), infiltration of the skull base (p=0.021), infiltration of the orbita (p=0.041), and the type of therapy (p<0.001): The 5-year DSS rate was 63% for patients operated only, 56% for all operated patients, 46% for patients undergoing surgery and radiotherapy, but only 21% for patients treated with radiotherapy+/-chemotherapy. Multivariate analysis revealed that T classification (p=0.042), N classification (p=0.035), M classification (p=0.007), UICC stage (p=0.038), and type of therapy (p=0.038) were independent prognostic factors for DSS.


CONCLUSIONS
Radical surgery is recommended for stage I/II sinonasal carcinomas. Stage III/IV carcinomas still have a poor prognosis, but multimodal treatment seems to favor the outcome.
Guntinas-Lichius
O
O
Clinic of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, D-50924 Koeln, Germany. orlando.guntinas@med.uni-jena.de
Kreppel
M P
MP
Stuetzer
H
H
Semrau
R
R
Eckel
H E
HE
Mueller
R P
RP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000970:Antineoplastic Agents