title: Treatment outcomes between concurrent chemoradiotherapy and combination of surgery, radiotherapy, and/or chemotherapy in stage III and IV maxillary sinus cancer: multi-institutional retrospective analysis.
abstract: OBJECTIVE
  The incidence of maxillary sinus cancer (MSC) is extremely rare, representing less than 1% of all cancers. Because of its rarity, the management of locally advanced MSC is a challenging issue. The objective of the present study was to retrospectively compare the efficacy of 2 traditional treatment strategies, concurrent chemoradiotherapy (CCRT) versus combination of surgery and radiotherapy and/or chemotherapy (SRCT) in MSC.
  
  
  METHODS
  From 1989 to 2010, 65 patients with histologically confirmed stage III or IVA/IVB were retrospectively analyzed.
  
  
  RESULTS
  The median age of our subjects was 60 years (range 36 to 81). The present study involved 18 women (27.7%) and 47 men (72.3%). Of the 65 patients, 52 (80.0%) had squamous cell carcinoma. The TNM stage was stage III, as determined by the American Joint Committee on Cancer, 6th edition, in 27 patients (41.5%). Stage IVA or IVB was observed in 38 patients (58.5%). Of the 65 patients, 41 underwent treatment. Of these 41 patients, 26 and 15 patients underwent SRCT and CCRT, respectively. During the 75.6 months (range 6.4 to 249.4) of median follow-up, the median progression-free survival duration was 45.1 months (95% confidence interval 0.0 to 142.7). The 5-year overall survival rate was 64.8%. However, the patients who had undergone surgery had better progression-free survival (hazard ratio 2.363, 95% confidence interval 1.098 to 5.085, P = .028) and overall survival (hazard ratio 4.989, 95% confidence interval 1.646 to 15.118, P = .004). The SRCT group had a better progression-free survival (P = .043) and overall survival (P = .029) duration than did the CCRT group.
  
  
  CONCLUSIONS
  SRCT might be superior to CCRT for locally advanced MSC. Additional studies comparing the treatment outcomes of CCRT with SRCT are warranted.
authors.affiliation: Department of Internal Medicine, Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea.
authors.forename: Jung Hun
authors.initials: JH
authors.lastname: Kang
authors.forename: Su Hee
authors.initials: SH
authors.lastname: Cho
authors.forename: Jin Pyeong
authors.initials: JP
authors.lastname: Kim
authors.forename: Ki Mun
authors.initials: KM
authors.lastname: Kang
authors.forename: Kyu Sup
authors.initials: KS
authors.lastname: Cho
authors.forename: Wontaek
authors.initials: W
authors.lastname: Kim
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Seol
authors.forename: Suee
authors.initials: S
authors.lastname: Lee
authors.forename: Heon Soo
authors.initials: HS
authors.lastname: Park
authors.forename: Won Joo
authors.initials: WJ
authors.lastname: Hur
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Choi
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Oh
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000601:surgery / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000601:surgery / Q000628:therapy; D059248:Chemoradiotherapy; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome