Clinical and biological prognostic factors in 179 cases with sinonasal carcinoma treated in the Italian Piedmont region.
OBJECTIVE
In spite of aggressive surgery and high-dose radiotherapy, the long-term survival of patients with sinonasal cancer remains disappointing. In this paper, we report data from 179 consecutive cases treated in the Italian Piedmont region between 1996 and 2000 according to a fixed protocol.


METHODS
Clinical and pathological data and the following biological parameters were analyzed: microvessel density and growth fraction by CD31 and Ki-67 positivity, respectively, and immunohistochemical expression of vascular endothelial growth factor (VEGF).


RESULTS
The median follow-up period was 75 months (range 45-108 months). Median overall survival was 26 months; 2- and 5-year overall survival rates were 52 and 36%, respectively. Patients with T1-T2 adenocarcinoma and squamous cell cancers (SCC) had better median survival than those with other lesions (p < 0.05). Patients treated with surgery with or without radiotherapy had better survival (p < 0.01), while chemotherapy had a marginally favorable effect (p = 0.09). The type of surgery and radiotherapy dose had no impact on survival; in contrast, there was a strong association between Ki-67 expression and microvessel density and overall survival (p < 0.05 and p = 0.039, respectively), while VEGF-C was a prognostic factor in SCC patients only (p < 0.05).


CONCLUSIONS
In sinonasal cancer, tumor stage and histology have a clear impact on survival; surgery with or without radiotherapy represents the main choice of treatment for such tumors. The efficacy of neoadjuvant and concomitant chemoradiotherapy needs to be further investigated. The proliferative index and angiogenesis show a major role in the natural history of this cancer.
Airoldi
Mario
M
Department of Medical Oncology, San Giovanni Battista Hospital, Turin, Italy.
Garzaro
Massimiliano
M
Valente
Guido
G
Mamo
Carlo
C
Bena
Antonella
A
Giordano
Carlo
C
Pecorari
Giancarlo
G
Gabriele
Pietro
P
Gabriele
Anna Maria
AM
Beatrice
Fabio
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010255:Paranasal Sinus Neoplasms / Q000098:blood supply / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000032:analysis; D011379:Prognosis; D015996:Survival Rate; D042582:Vascular Endothelial Growth Factor C / Q000032:analysis
D019408:Platelet Endothelial Cell Adhesion Molecule-1; D042582:Vascular Endothelial Growth Factor C