Paranasal sinus malignancies: An 18-year single institution experience
Paranasal sinus malignancies: An 18-year single institution experience
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DOI：
10.1097/00005537-200211000-00010
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发表时间：
2002-11-01
期刊：
影响因子：
2.6
通讯作者：
Wolf, GT
中科院分区：
文献类型：
--
作者：
Myers, LL;Nussenbaum, B;Wolf, GT
目标.描述一个单一机构在18年时间内治疗鼻窦恶性肿瘤的经验，报告长期生存率，并确定预后因素。研究设计：回顾性病历审查。方法.研究对象为1980年至1997年在一家机构接受鼻窦恶性肿瘤治疗的141例患者，随访时间至少为3年。对性别、年龄、TNM分期、解剖部位、病理、治疗和复发率进行了回顾性分析。进行多变量分析以确定影响生存的因素。结果男女比例为1.6：1，中位患者年龄为60岁。大多数患者表现为T3/T4或局部晚期疾病（88%），NO状态（96%）和MO状态（96%）。上颌窦是最常见的受累部位（70%），其次是筛窦（26%）。最常见的恶性肿瘤是鳞状细胞癌（51%），其次是腺样囊性癌（12%）和腺癌（11%）。62%的研究组接受了手术作为多模态治愈性治疗计划的一部分或单独作为治愈性治疗。18例患者（13%）有不可切除的局部疾病，并接受非手术姑息治疗。Kaplan-Meier分析显示，5年和10年疾病特异性生存率分别为52%和35%。多变量分析显示T4分期（P = 0.005）、N阳性分期（P = 0.009）和M阳性分期（P = 0.018）对生存率有负面影响。72名患者（51%）在初始治疗后的中位时间336天内出现疾病复发。结论：大多数副鼻窦恶性肿瘤患者表现为局部晚期病变。晚期T分期、区域转移和远处转移是生存率低的高度预测因素。复发率很高，通常发生在治疗后的第一年内。
Objectives. To characterize a single institution experience with management of paranasal sinus malignancies during an 18-year time period, report long-term survival rates, and identify prognostic factors. Study Design: Retrospective chart review. Methods. Studied were 141 patients treated for a paranasal sinus malignancy at a single institution from 1980 to 1997 with a minimum 3-year follow-up. Gender, age, TNM stage, anatomic site, pathology, treatment, and recurrence rates were reviewed. Multivariate analysis was performed to determine factors affecting survival. Results. The male to female ratio was 1.6:1, and the median patient age was 60 years. Most patients presented with T3/T4 or locally advanced disease (88%), NO status (96%), and MO status (96%). The maxillary sinus was the most commonly affected site (70%), followed by the ethmoid sinus (26%). The most common malignancy was squamous cell carcinoma (51%), followed by adenoid cystic carcinoma (12%) and adenocarcinoma (11%). Sixty-two percent of this study group underwent surgery as part of a multimodality curative treatment plan or alone as curative treatment. Eighteen patients (13%) had unresectable local disease and received non-surgical palliative treatment. Kaplan-Meier analysis revealed the 5-year and 10-year disease-specific survival was 52% and 35%, respectively. Multivariate analysis revealed T4 stage (P = .005), N-positive stage (P = .009), and M-positive stage (P = .018) negatively impacted survival. Seventy-two patients (51%) developed recurrent disease at a median time of 336 days after initial treatment. Conclusions: Most patients with paranasal sinus malignancies presented with locally advanced disease. Advanced T stage, regional, and distant metastasis are highly predictive of poor survival. Recurrence rate is high and typically occurs within the first year after treatment.