title: Endoscopic resection followed by adjuvant radiotherapy for sinonasal intestinal-type adenocarcinoma: Retrospective analysis of 30 consecutive patients.
abstract: BACKGROUND
  Intestinal-type adenocarcinoma (ITAC) is a rare and locally aggressive occupation-related tumor. Currently, endoscopic-assisted resection and advances in irradiation modalities (3D conformal radiotherapy/intensity-modulated radiation therapy [IMRT]) are emerging as an alternative to traditional open surgery and conventional radiotherapy.
  
  
  METHODS
  Retrospective analysis of 30 consecutive patients affected with sinonasal ITAC, primarily treated by an endoscopic approach followed by 3D conformal radiotherapy/IMRT at a single institution, from 2003 to 2010.
  
  
  RESULTS
  The 5-year overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), and recurrence-free survival (RFS) were 72.7% ± 9.6%, 78% ± 9.5%, 67.9% ± 10.7%, and 69.2% ± 9.4%, respectively (mean follow-up, 48 months). No major complications or serious toxicities were observed. Prognostic factors were stage of disease at diagnosis, development of recurrences, status of surgical margins, grading, tumoral pattern of growth, and proliferative index (Ki-67).
  
  
  CONCLUSIONS
  The low morbidity of endoscopic approaches, the acceptable toxicity of modern irradiation modalities, and these promising survival rates, indicate that this treatment strategy might be considered a safe, minimally invasive, and maximally effective option for treating selected sinonasal ITAC.
authors.affiliation: Department of Radiotherapy, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Antognoni
authors.forename: Mario
authors.initials: M
authors.lastname: Turri-Zanoni
authors.forename: Stefania
authors.initials: S
authors.lastname: Gottardo
authors.forename: Marinella
authors.initials: M
authors.lastname: Molteni
authors.forename: Luca
authors.initials: L
authors.lastname: Volpi
authors.forename: Carla
authors.initials: C
authors.lastname: Facco
authors.forename: Stefania
authors.initials: S
authors.lastname: Freguia
authors.forename: Cinzia
authors.initials: C
authors.lastname: Mordacchini
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: AlQahtani
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bignami
authors.forename: Carlo
authors.initials: C
authors.lastname: Capella
authors.forename: Paolo
authors.initials: P
authors.lastname: Castelnuovo
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007414:Intestinal Neoplasms / Q000473:pathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D010255:Paranasal Sinus Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: endoscopic endonasal; head and neck cancer; radiotherapy; sinonasal adenocarcinoma; skull base