Maxillary sinus and hard palate squamous cell carcinoma: Multi-institutional experience

Abstract

Background: Although maxillary cancers are rare, squamous cell carcinoma (SCC) is the most common pathologic type. As such, c, omplications of the tumor and its treatment can affect the quality of life. Accordingly, multidisciplinary treatment is a must. Aim of the Work: To review the clinico-epidemiologic features of maxillary sinus squamous cell carcinoma (MxSSCC) in 2 cancer institutions in the Delta region with an analysis of prognostic factors. Patient and Methods: Sixty-four MxSSCC cases were included from January 2000 to June 2018 inclusive. Descriptive and survival analyses were carried out. Cox regression analysis was done to define prognostic factors. Results: The majority of patients were male, smokers, of the age range (40-69 years) showing high T staging and high node positivity. The treatment of the primary tumor ranged from surgery +/-adjuvant treatment in 34 patients (53%), definitive radiotherapy (DRT) +/-chemotherapy; whether induction, concomitant, or both in 25(39%) patients. Neck treatment varied between node dissection +/-radiotherapy (RT) in 25 cases (39.1%), DRT [28 cases (43.7%)], and 6 patients (9.4%) were under the wait and watch strategy. The median overall survival (OAS) was 61 months (range: 2-121) and the 5-years OAS was 51.6%. The median progression-free survival (PFS) was 44 months (range: 1-117) and the 5-years PFS was 40.6%. Multivariate analysis of prognostic factors affecting OAS and PFS revealed that low stage and free safety margin were independent positive prognostic factors. Conclusion: MxSSCC is rare. Most of the cases were presented at a late stage. Surgery +/-adjuvant treatment was the commonest modality for treating the primary tumor, while DRT+/-was used for treating the primary and nodes in nearly 40% of the cases. Low stage and free safety margins were the positive independent prognostic factors. There is a need to investigate stronger treatments for this cancer.