Cell carcinoma of the paranasal sinuses and skull base.
OBJECTIVE
To evaluate patients with squamous cell carcinoma of the paranasal sinus and skull base for factors that might predict clinical outcome.


METHODS
A multi-institutional 13-year retrospective review of anterior skull base malignancies.


RESULTS
Of 73 patients with anterior skull base malignancies, squamous cell carcinoma was the most prevalent-30 patients or 41%. Twenty-three patients underwent craniofacial surgery with or without adjuvant chemotherapy. Seven patients, deemed unresectable or not willing to have surgery, were treated with standard radiation protocols often with chemotherapy. The 3- and 5-year survival rates after surgery were 32% and 16%, respectively, compared to a 28% survival rate at 3 and 5 years for the nonsurgical group. Most tumors were in advanced stages accounting for a relatively poor survival in both groups. A Cox regression analysis demonstrated that age (P = .0172) was an independent determinant of poor outcome. Although 3- and 5-year survival of tumors free of sphenoid sinus, dura, retromaxillary, and ptyerygoid space, and orbit treated with surgery showed no significant difference to those patients with involvement, their median time of survival was increased for all anatomical regions.


CONCLUSIONS
Squamous cell carcinoma of the sinus invading the skull base carries a very poor prognosis regardless of treatment modality. Surgery with adjunctive radiotherapy and/or chemotherapy offers a survival advantage over nonsurgical methods, but treatment should be individualized weighing prognostic factors, such as age, stage, and anatomical extension with morbidity of treatment.
McKay
Shawn P
SP
Department of Otolaryngology--Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI 48202, USA.
Shibuya
Terry Y
TY
Armstrong
William B
WB
Wong
Hau-Sin
HS
Panossian
Apraham M
AM
Ager
Joel
J
Mathog
Robert H
RH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010255:Paranasal Sinus Neoplasms / Q000453:epidemiology / Q000628:therapy*; D015995:Prevalence; D016016:Proportional Hazards Models; D011788:Quality of Life; D019292:Skull Base Neoplasms / Q000453:epidemiology / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome