Carcinoma of the nasal cavity and paranasal sinuses in Denmark 1995–2004

Abstract

Objective. To evaluate the treatment outcome for sino-nasal carcinomas in Denmark from 1995-2004 and compare the results to the previous Danish survey covering 1982-1991. Design. Retrospective follow-up. Materials and methods. In the fi ve Danish head and neck oncology centres, charts of all consecutive patients with sino-nasal carcinomas were reviewed and data extracted to a common database. Altogether 242 patients from the period 1995-2004 were identifi ed. Of these 162 (67%) were male and 80 (33%) female. Histologies included squamous cell carcinoma (55%), adenocarcinoma (28.5%), adenoid-cystic carcinoma (5.0%), undifferentiated carcinoma (4.5%), transitiocellular carcinoma (1.7%), mucoepidermoid carcinoma (0.8%), neuroendocrine carcinoma (2.5%), small cell carcinomas (1.2%) and carcinomas not otherwise specifi ed (0.8%). Treatments included radiotherapy alone 79 (33%), surgery alone 29 (12%), combined surgery and radiotherapy 96 (40%), palliative/no treatment 38 (16%). A total of 204 (86%) patients were treated with curative intent. Results. Of the 204 patients treated with curative intent, 94 (46%) relapsed. Most failures were in T-site (63, 30%). N-site failures were 10 (5%) and M-site failures six (3%). Failure occurring in TϩN-site, TϩM-site, NϩM-site and TϩNϩM-site were seven (3%), two (1%), one (0.5%) and fi ve (3%) respectively. The 5-year actuarial local, nodal and loco-regional control rates were 55Ϯ4%, 86Ϯ3%, 49Ϯ4%, respectively. The overall 5-year actuarial survival rate for the entire cohort was 47Ϯ3%, and the corresponding cancer-specifi c 5-year actuarial survival rate was 57Ϯ3%. Female gender, nasal cavity tumour, adenocarcinoma and low clinical stage were signifi cant positive prognostic factors in univariate analysis. A Cox multivariate analysis showed that only tumour site and clinical stage were independent signifi cant prognostic factors. Conclusion. The current series has confi rmed stage and tumour site as independent prognostic factors. Compared to the previous Danish survey covering the period 1982-1991, the overall survival and cancer-specifi c survival rates have improved signifi cantly.

A national series of 244 sinonasal cancers in Finland in 1990–2004

“…The same survival rate may result from similar stage distribution of the disease and the same treatment approach given to the patients [5]. The authors in the Danish paper stated that the stage (by the UICC staging system) was an independent prognostic factor, which was also supported by our study.…”

“…In a recent meta-analysis by Scurry et al [13], the regional recurrence rate was 18.1%, and the authors advocated that patients with intranasal SCCs that demonstrate high-risk characteristics should be considered for elective treatment of the neck with either surgery or radiation therapy. The Danish group, however, does not recommend elective neck treatment for all patients [5]. Our initial incidence of node-positive tumours was quite low, and there were only a few regional recurrences (9%) among patients treated with curative intent.…”

“…The improved survival was also detected in Denmark between the periods of 1982-1991 and 1995-2004 [5]. Recent studies have advocated multimodality treatment for at least advanced cases of sinonasal cancer, but some controversy still exists concerning the frequency of regional metastases and the implication of elective neck treatment [2,4,[6][7][8][9][10].…”

Paranasal sinus squamous cell carcinoma incidence and survival based on Surveillance, Epidemiology, and End Results data, 1973 to 2009

“…Malignant tumors originating from the nose or the paranasal sinuses are rare, [1][2][3][4] representing 3% of all malignancies of the head and neck region. [1][2][3]5,6 They arise in air-filled cavities, which usually become infiltrated by tumor before signs and symptoms develop; therefore, most patients at diagnosis present with advanced stage disease and have extensive involvement of adjacent sites.…”

IMRT for Nasal Tumors – Local Control and Cosmetic Outcome

“…Surgical removal often implies complex reconstruction which may end in disfiguring results and consecutively essential impairment of quality of life. Radiation therapy (RT) can be carried out as external beam or brachytherapy, with good local control rates of 67-92% after 5 years [2][3][4][5][6].…”