Paranasal sinuses malignancies: A 12-year review of clinical characteristics

Abstract

BackgroundInadequate epidemiologic investigations of the paranasal sinuses malignancies prompted this retrospective study with special emphasis on a major group of 111 tumors.Material and MethodsClinical records of 111 patients with histologically confirmed malignant tumors of the paranasal sinuses were investigated retrospectively from April 2000 to January 2012. Collection of data included demographic information, clinical manifestations, treatment plans, and histopathology of the tumor.ResultsThere were 69 (62.16%) male and 42 (37.83%) female patients (male-to-female ratio of 1.6:1), with a median age of 49±12.2 years (range 21 to 88 years). A high level of occurrence was noticed in the fifth (26.3%) decade of life. The most frequent histological types were squamous cell carcinoma (43.5%) and adenoid cystic carcinoma (19%). Among clinical manifestations, nasal obstruction was the most frequent followed by diplopia, and facial swelling. Fifty three patients (47.74%) were treated with combined approach of surgery and radiation therapy.ConclusionsParanasal sinuses malignancies are rare conditions with nonspecific symptoms which make early diagnosis of the lesions more challenging. The optimal therapeutic protocol for patients suffering from these tumors is still a somewhat controversial entity and requires further studies. Key words:Paranasal sinuses, malignancy, surgery,radiotherapy.

A comprehensive comparative analysis of treatment modalities for sinonasal malignancies

“…Such a locally aggressive disease emphasizes the importance of improving local therapy. Local disease recurrence has been reported as a predominant treatment failure pattern in the literature . This also is supported by the findings presented herein that patients with surgically accessible tumors fared better.…”

“…Consistent with published retrospective series, the majority of patients presenting with sinonasal cancer were male, were non‐Hispanic white, and had squamous cell histology . The results of the current study also demonstrated worse outcomes for African American patients and improved outcomes for Hispanic patients compared with non‐Hispanic white patients.…”

“…Overall, to the best of our knowledge, the majority of prior studies regarding this topic consist of small cohorts or case series. Some of these studies failed to demonstrate an advantage to multimodality therapy, whereas others demonstrated improved survival outcomes, which is consistent with the findings of the current study . One reason that earlier studies might have failed to demonstrate an improvement with multimodality therapy may be the radiotherapy techniques used, compared with the modern cohort of patients in the current study.…”

“…The optimal sequencing of chemotherapy and radiotherapy for patients with sinonasal carcinoma remains controversial . Small reports have shown a benefit for induction chemotherapy, and numerous institutional and multi‐institutional series have shown a benefit for adjuvant therapy . To our knowledge, definitive concurrent chemoradiotherapy has been less studied in this disease, with a few series demonstrating low survival outcomes and in‐field failures with biologically equivalent doses <65 grays .…”

“…Therapy encompassing a multimodality approach has been shown to improve treatment outcomes. [3][4][5][6][7][8] Although it has been established that maximal safe surgical resection yields the best overall survival (OS) outcomes, 2 the role of postoperative radiotherapy is less well defined in the treatment of this disease. Some older series found no survival benefit with adjuvant therapy, [9][10][11] whereas others demonstrated that combined radiotherapy and surgery yield better survival rates.…”