Surgical treatment of squamous cell carcinoma of the maxilla and nasal sinuses.
OBJECTIVE
In the treatment of oral squamous cell carcinoma of the maxilla and paranasal sinuses, radical surgery and reconstruction with free flaps is accepted among many clinics. Nevertheless, the treatment protocols vary considerably. This study was performed to present our experience in the treatment of maxillary squamous cell carcinoma with surgical means alone, and to try to identify crucial prognostic factors for the patients' survival.


METHODS
Thirty-six patients with primary resectable squamous cell carcinoma were included in the study. The mean age was 63 years (43-87 years) and 50% presented in advanced tumor stage (T4). Five patients (14%) already had cervical metastases. All patients were treated by radical surgery alone, and the resulting defects were closed by means of local or free flaps or the use of an obturator, respectively.


RESULTS
The overall 5-year survival rate was 64%; the recurrence rate was 33%. Only patients who presented in T3 or T4 stages or had no free resection margins died during the follow-up period. Sixty-nine percent of the patients who died passed away within the first 12 months of follow-up. The 5 patients with cervical metastases received therapeutic neck dissection and showed no regional recurrence. In cases of R1 resection, adjuvant radiotherapy was applied.


CONCLUSIONS
The sole surgical treatment of squamous cell carcinomas of the maxillary region led to good results, and can therefore be seen as a valuable strategy. Free resection margins and early detection of the tumor are the most important factors for success.
Kermer
Christian
C
University Hospital for Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.
Poeschl
Paul W
PW
Wutzl
Arno
A
Schopper
Christian
C
Klug
Clemens
C
Poeschl
Ellen
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D006801:Humans; D008437:Maxilla / Q000601:surgery; D008441:Maxillary Neoplasms / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D019647:Oral Surgical Procedures / Q000379:methods*; D010158:Palatal Obturators; D010255:Paranasal Sinus Neoplasms / Q000473:pathology / Q000601:surgery*; D010256:Paranasal Sinuses / Q000601:surgery; D011379:Prognosis; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps