title: Multicenter study to assess endoscopic resection of 159 sinonasal adenocarcinomas.
abstract: OBJECTIVE
  This study was designed to assess the efficacy and morbidity of the endoscopic endonasal approach for the treatment of sinonasal adenocarcinomas.
  
  
  METHODS
  This was a retrospective, multicenter study of nine French tertiary referral centers, including untreated patients. All patients were operated by an endoscopic approach. Tumors were classified according to the UICC 2002. Demographic, therapeutic, histological, morbidity data, and the course of the disease were recorded. Survival rates were obtained using the Kaplan-Meier method.
  
  
  RESULTS
  A total of 159 patients were included with a mean age of 69 years. There were 19T1, 62T2 (1M1), 36T3 (1N1), 26T4a, and 16T4b (1N2a-1N2c). The mean duration of hospitalization was 4.4 days. The histologic outcomes showed that the olfactory cleft, the posterior and anterior ethmoid sinus, and the sphenoid, maxillary, and frontal sinuses were invaded in 95, 64, 55, 19, 7, and 3 % of cases, respectively. Histologic margins were positive in 17 % (1T1, 4T2, 3T3, 2T4a, and 8T4b). In total, 130 patients received adjuvant radiotherapy on the primary tumor site (58 Gy), 24 cases were not irradiated, and 5 refused treatment. The mean follow-up was 32.5 ± 24 months. The complication rate was 19 %: 6 epistaxis, 3 meningitis, 6 CSF leaks, 2 dacryocystitis, and 8 septoplasties. The recurrence rate was 17.6 % (28 cases) within 23 ± 21 months. Eleven patients underwent a second surgical procedure. Nine patients died of their disease (3T2, 2T3, 4T4b). The global and disease-specific, recurrence-free survival rate at 3 years was 74 and 84 % respectively.
  
  
  CONCLUSIONS
  The endoscopic approach seems to be efficient to remove sinonasal adenocarcinoma with low morbidity.
authors.affiliation: Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Rangueil-Larrey, Toulouse, France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Vergez
authors.forename: Marie Devars
authors.initials: MD
authors.lastname: du Mayne
authors.forename: Andre
authors.initials: A
authors.lastname: Coste
authors.forename: Patrice
authors.initials: P
authors.lastname: Gallet
authors.forename: Roger
authors.initials: R
authors.lastname: Jankowski
authors.forename: Xavier
authors.initials: X
authors.lastname: Dufour
authors.forename: Christian
authors.initials: C
authors.lastname: Righini
authors.forename: Emile
authors.initials: E
authors.lastname: Reyt
authors.forename: Olivier
authors.initials: O
authors.lastname: Choussy
authors.forename: Elie
authors.initials: E
authors.lastname: Serrano
authors.forename: Louis
authors.initials: L
authors.lastname: Crampette
authors.forename: Christian
authors.initials: C
authors.lastname: Debry
authors.forename: Ludovic
authors.initials: L
authors.lastname: de Gabory
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000368:Aged; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008207:Lymphatic Metastasis; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate