title: Sinonasal malignancies: long term follow up after surgical management-an analysis of outcomes.
abstract: Sinonasal malignancies are rare and survival analysis in affected patients is arduous and perplexing due to various factors. In this review article, attempt has been made to overcome some of those factors while analysing survival outcomes.
  
  
  OBJECTIVE
  The aim of this study was to share the experience of a tertiary care centre in the surgical management of sinonasal malignancies over 12 years.
  
  
  METHODS
  This study is a retrospective chart review, and in this study, hospital records of 58 patients with biopsy proven sinonasal malignancies were studied. Only the patients undergoing primary or salvage surgery at our institution from May-2000 to April-2012 with a minimum follow up of 2 years were included. Statistical analyses such as means, proportions, Kaplan-Meier analysis and Cox's regression model were done.
  
  
  RESULTS
  Majority of the patients were males (n = 43) belonging to fourth and fifth decades. Squamous cell carcinoma was the most common (n = 17) histopathological type, followed by adenoid cystic carcinoma (n = 14). Majority presented with stage IV disease (n = 42). 17 patients were operated for recurrent disease. Over all 5 year survival was 72 % and disease free survival was 44 %. Separate analysis for epithelial and matched non-epithelial group showed poorer prognosis with epithelial group (p = 0.0120). Multivariate analysis showed histopathological type (epithelial) and presence of pathological risk factors (positive margins and/or perineural invasion) affecting survival.
  
  
  CONCLUSIONS
  Advanced stage presentation is the norm for sinonasal malignancies. This study noted a 5 year overall survival of 72 % and disease free survival of 44 %. Epithelial histopathology carries poorer prognosis then other counterparts and incomplete removal is shown to add to poor prognosis independently.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery,, All India Institute of Medical Sciences, Room No. 4057, 4th Floor, Teaching Block, Ansari Nagar, New Delhi, 110029 India.
authors.forename: K
authors.initials: K
authors.lastname: Devaraja
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery,, All India Institute of Medical Sciences, Room No. 4057, 4th Floor, Teaching Block, Ansari Nagar, New Delhi, 110029 India.
authors.forename: Kapil
authors.initials: K
authors.lastname: Sikka
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery,, All India Institute of Medical Sciences, Room No. 4057, 4th Floor, Teaching Block, Ansari Nagar, New Delhi, 110029 India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery,, All India Institute of Medical Sciences, Room No. 4057, 4th Floor, Teaching Block, Ansari Nagar, New Delhi, 110029 India ; Department of ENT, All India Institute of Medical Sciences, Room No. 4067, 4th Floor, Teaching Block, Ansari Nagar, New Delhi, 110029 India.
authors.forename: Alok
authors.initials: A
authors.lastname: Thakar
keywords: Long term outcomes; Sinonasal malignancies; Squamous cell carcinoma; Survival analysis