Background
Frontal sinus carcinoma is commonly seen as an extension of the ethmoid sinus, overlying skin, or lacrimal gland. The existence of this disease has been unclear. We aimed to describe the occurrence of primary frontal sinus carcinoma.
Methods
We conducted a systematic literature review and a retrospective review of the medical records at our institution in the past 10 years.
Results
Sixty-four articles were included in the literature review. Most frontal sinus carcinomas involved surrounding structures as the sphenoid or ethmoid sinus, and a primary origin in the frontal sinus could not be confirmed. No cases of primary frontal sinus carcinoma were identified at our hospital.
Conclusion
Isolated primary frontal sinus carcinoma, if exists, is very rare. There is uncertainty regarding the primary origin of frontal sinus carcinoma in most studies. The frontal sinus seems to be immune from primary carcinoma. Further studies are needed to explain such immunity.
Objective: To determine the prognostic value of lymph node density (LND) as a predictor for tumor recurrence in patients with advanced laryngeal carcinoma undergoing curative surgery. Patients and Methods: This is a prospective study, included 87 patients, diagnosed with locally advanced laryngeal carcinoma (T3 & T4a) and carried out total laryngectomy with neck dissection, presented to otorhinolaryngology outpatient clinic at faculty of medicine, Cairo university, Egypt, between June 2018 and May 2019. LND was determined by calculating the ratio between number of resected lymph nodes (LNs) positive for malignancy and total number of resected LNs. The mean follow up duration for tumor recurrence was 24 months (range 17 -29 months). Results: LND, number of positive LNs, involved surgical margins, presence of metastatic LNs and adjuvant chemoradiation were statistically significant predictors for disease recurrence in univariate analysis. LND was the only independent predictor of recurrence in pathologically positive neck node (pN+) patients in multivariate analysis. In patients with LND > 0.066, hazard ratio for disease recurrence was 3.887 (P=0.021), and for nodal recurrence was 6.453 (P=0.008), reaching LND > 0.25 significantly increased hazard ratio for recurrence to 5.838 (P=0.001), and for nodal recurrence to 9.329 (P=0.001) compared with pN0 cases. Conclusion: LND was found to be the only independent predictor for disease recurrence in pN+ laryngeal cancer. LND should be used complementary to the conventional TNM staging to assess the precise risk of treatment failure and planning of possible postoperative adjuvant treatment.
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