Lymph node metastases in malignant tumors of the paranasal sinuses
Lymph node metastases in malignant tumors of the paranasal sinuses
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DOI：
10.1001/archoto.2007.30
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发表时间：
2008-02-01
影响因子：
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通讯作者：
Rossi, Marco
中科院分区：
文献类型：
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作者：
Cantu, Giulio;Bimbi, Gabriella;Rossi, Marco
目的：为了评估淋巴结的参与和其预后价值的副鼻窦恶性肿瘤的频率，特别是在上颌窦鳞状细胞cancer.Design：回顾性研究。设置：三级癌症center.Patients从1968年1月至2003年3月704例连续手术治疗的副鼻窦恶性肿瘤的病历进行了审查。根据美国癌症联合委员会-国际抗癌联盟2002年分类对肿瘤进行分期。只有临床阳性淋巴结的患者进行了neck disorder.Main结果测量：淋巴结转移（在介绍或在后续，发生单独，或并发局部复发和/或远处转移）。同时分析局部复发（单独发生或同时发生远处转移）、远处转移（单独发生）和总生存率。结果：肿瘤部位为筛窦305例，上颌窦399例。基线时，5例患者筛窦组为1.6%，上颌窦组8.3%的患者有阳性淋巴结（P < .001）;随访期间，淋巴结复发（单独或同时与T和/或M复发）分别发生在15和51例患者中，相应的5年发病率估计值分别为4.3%和12.5%（P = .001）。上颌窦鳞癌淋巴结转移发生率最高，尤其是T2期肿瘤。五年总生存率估计为45.3%的患者与NO肿瘤和0%的那些与N+（N1，N2，或N3）筛窦肿瘤，50.6%和16.8%，分别为患者与上颌窦tumors.Conclusions：淋巴结转移是一个不良的预后因素与副鼻窦恶性肿瘤患者。这些转移的发生率很低，特别是在筛窦肿瘤。对于上颌窦T2期鳞状细胞癌和筛窦未分化癌，可能考虑对无肿瘤患者（手术或放疗）进行颈部预防性治疗。
Objective: To assess the frequency of nodal involvement and its prognostic value in malignant tumors of the paranasal sinuses, particularly in maxillary sinus squamous cell carcinoma.Design: Retrospective review.Setting: Tertiary cancer center.Patients The medical records of 704 consecutive patients surgically treated for malignant tumors of the paranasal sinuses from January 1968 to March 2003 were reviewed. The tumors were staged according to American joint Committee on Cancer-International Union Against Cancer 2002 classification. Only patients with clinically positive nodes underwent a neck dissection.Main Outcome Measures: Lymph node metastases (at presentation or during follow-up, occurring alone, or with concurrent local recurrence and/or distant metastasis). Also analyzed were local recurrence (occurring alone or with concurrent distant metastasis), distant metastasis (occurring alone), and overall survival.Results: The tumor site was the ethmoid sinus in 305 cases and maxillary sinus in 399 cases. At baseline, 5 patients (1.6%) in the ethmoid sinus group and 33 (8.3%) in the maxillary sinus group presented with positive nodes (P < .001); during follow-up, nodal recurrences (alone or simultaneous with T and/or M recurrence) occurred in 15 and 51 patients, respectively, and the corresponding 5-year incidence estimates were 4.3% and 12.5% (P = .001). The highest incidence of node metastases was found in maxillary sinus squamous cell carcinoma, particularly in T2 tumors. Five-year overall survival estimates were 45.3% for patients with NO tumors and 0% for those with N+ (N1, N2, or N3) ethmoid sinus tumors, and 50.6% and 16.8%, respectively, for patients with maxillary sinus tumors.Conclusions: Lymph node metastases are a poor prognostic factor for patients with malignant tumors of the paranasal sinuses. The incidence of these metastases is low, particularly in ethmoid sinus tumors. A prophylactic treatment of the neck in patients with NO tumors (surgery or radiotherapy) might be considered in T2 squamous cell carcinoma of the maxillary sinus and in undifferentiated carcinoma of the ethmoid sinus.