Skull Base 2011; 21(4): 243-248
DOI: 10.1055/s-0031-1280686
ORIGINAL ARTICLE

© Thieme Medical Publishers

Craniofacial Resection for Sinonasal Malignant Tumors: Statistical Analysis of Surgical Outcome over 17 Years at a Single Institution

Seiichiro Mine1 , Naokatsu Saeki1 , Kentaro Horiguchi1 , Toyoyuki Hanazawa2 , Yoshitaka Okamoto2
  • 1Department of Neurological Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan
  • 2Department of Otorhinolaryngology–Head and Neck Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan
Further Information

Publication History

Publication Date:
09 June 2011 (online)

ABSTRACT

We present a retrospective analysis of surgical outcome of sinonasal malignant tumors. Overall survival (OS), disease-specific survival (DSS), local control (LC), and disease-free survival (DFS) were calculated in 32 patients. Prognostic factors for survival and functional outcomes were investigated. The median follow-up period was 70 months. At 5 years, OS, DSS, LC, and DFS rates were 0.722, 0.745, 0.851, and 0.707, respectively. Prognostic factors for poor OS were involvement of the frontal sinus (p = 0.023), T classification (T4, p = 0.025), surgical complications (p = 0.029), chemotherapy (p = 0.035) postsurgical infection (p = 0.043), involvement of the orbit (p = 0.048), histology (squamous cell carcinoma, p = 0.049), and radiotherapy (p = 0.043). Prognostic factors for poor DSS were radiotherapy (p = 0.030), chemotherapy (p = 0.036), positive surgical margin (p = 0.034), and T classification (T4, p = 0.050). LC was adversely influenced by surgical procedure (combined frontotemporal resection, p = 0.035) and positive surgical margin (p = 0.049). DFS was adversely influenced by positive surgical margin (p = 0.001). Prognostic factors for poor functional outcome were postsurgical infection (p = 0.039), postsurgical complications (p = 0.040), tumor location (maxillary sinus, p = 0.042, orbit, p = 0.0002), number of sinuses involved (number of sinuses involved was inversely proportional to functional outcome, p = 0.027), T classification (T4 p = 0.007), pathology (squamous cell carcinoma, p = 0.023), and chemotherapy (p = 0.048). Craniofacial resection was an effective surgical option.

REFERENCES

  • 1 Smith R R, Klopp C T, Williams J M. Surgical treatment of cancer of the frontal sinus and adjacent areas.  Cancer. 1954;  7 (5) 991-994
  • 2 Ketcham A S, Wilkins R H, Vanburen J M, Smith R R. A combined intracranial facial approach to the paranasal sinuses.  Am J Surg. 1963;  106 698-703
  • 3 Fukuda K, Saeki N, Mine S et al.. Evaluation of outcome and QOL in patients with craniofacial resection for malignant tumors involving the anterior skull base.  Neurol Res. 2000;  22 (6) 545-550
  • 4 Kamata N. Middle fossa approach. In: Komatsuzaki A, Inuyama M, Honjo I, Moriyama H, eds. Atlas of otolaryngology, head and neck surgery. Vol. 2. Tokyo: Igaku-Shoin; 1999: 337-344
  • 5 Bentz B G, Bilsky M H, Shah J P, Kraus D. Anterior skull base surgery for malignant tumors: a multivariate analysis of 27 years of experience.  Head Neck. 2003;  25 (7) 515-520
  • 6 Guntinas-Lichius O, Kreppel M P, Stuetzer H, Semrau R, Eckel H E, Mueller R P. Single modality and multimodality treatment of nasal and paranasal sinuses cancer: a single institution experience of 229 patients.  Eur J Surg Oncol. 2007;  33 (2) 222-228
  • 7 McKay S P, Shibuya T Y, Armstrong W B et al.. Cell carcinoma of the paranasal sinuses and skull base.  Am J Otolaryngol. 2007;  28 (5) 294-301
  • 8 Patel S G, Singh B, Polluri A et al.. Craniofacial surgery for malignant skull base tumors: report of an international collaborative study.  Cancer. 2003;  98 (6) 1179-1187
  • 9 Thompson L DR. Sinonasal carcinomas.  Curr Diagn Pathol. 2006;  12 40-53
  • 10 Hoppe B S, Stegman L D, Zelefsky M J et al.. Treatment of nasal cavity and paranasal sinus cancer with modern radiotherapy techniques in the postoperative setting—the MSKCC experience.  Int J Radiat Oncol Biol Phys. 2007;  67 (3) 691-702
  • 11 Blanco A I, Chao K SC, Ozyigit G et al.. Carcinoma of paranasal sinuses: long-term outcomes with radiotherapy.  Int J Radiat Oncol Biol Phys. 2004;  59 (1) 51-58
  • 12 Bridger G P, Kwok B, Baldwin M, Williams J R, Smee R I. Craniofacial resection for paranasal sinus cancers.  Head Neck. 2000;  22 (8) 772-780
  • 13 Suarez C, Llorente J L, Fernandez De Leon R, Maseda E, Lopez A. Prognostic factors in sinonasal tumors involving the anterior skull base.  Head Neck. 2004;  26 (2) 136-144
  • 14 Rutter M J, Furneaux C E, Morton R P. Craniofacial resection of anterior skull base tumours: factors contributing to success.  Aust N Z J Surg. 1998;  68 (5) 350-353
  • 15 Salvan D, Julieron M, Marandas P et al.. Combined transfacial and neurosurgical approach to malignant tumours of the ethmoid sinus.  J Laryngol Otol. 1998;  112 (5) 446-450
  • 16 Dirix P, Nuyts S, Geussens Y et al.. Malignancies of the nasal cavity and paranasal sinuses: long-term outcome with conventional or three-dimensional conformal radiotherapy.  Int J Radiat Oncol Biol Phys. 2007;  69 (4) 1042-1050
  • 17 Cantù G, Solero C L, Mariani L et al.. Anterior craniofacial resection for malignant ethmoid tumors—a series of 91 patients.  Head Neck. 1999;  21 (3) 185-191
  • 18 Chen A M, Daly M E, El-Sayed I et al.. Patterns of failure after combined-modality approaches incorporating radiotherapy for sinonasal undifferentiated carcinoma of the head and neck.  Int J Radiat Oncol Biol Phys. 2008;  70 (2) 338-343
  • 19 Howard D J, Lund V J, Wei W I. Craniofacial resection for tumors of the nasal cavity and paranasal sinuses: a 25-year experience.  Head Neck. 2006;  28 (10) 867-873
  • 20 Gil Z, Abergel A, Spektor S, Shabtai E, Khafif A, Fliss D M. Development of a cancer-specific anterior skull base quality-of-life questionnaire.  J Neurosurg. 2004;  100 (5) 813-819
  • 21 Chen A M, Daly M E, Bucci M K et al.. Carcinomas of the paranasal sinuses and nasal cavity treated with radiotherapy at a single institution over five decades: are we making improvement?.  Int J Radiat Oncol Biol Phys. 2007;  69 (1) 141-147
  • 22 Jansen E P, Keus R B, Hilgers F J, Haas R L, Tan I B, Bartelink H. Does the combination of radiotherapy and debulking surgery favor survival in paranasal sinus carcinoma?.  Int J Radiat Oncol Biol Phys. 2000;  48 (1) 27-35
  • 23 Katz T S, Mendenhall W M, Morris C G, Amdur R J, Hinerman R W, Villaret D B. Malignant tumors of the nasal cavity and paranasal sinuses.  Head Neck. 2002;  24 (9) 821-829

Seiichiro MineM.D. Ph.D. 

Department of Neurological Surgery, Chiba University, Graduate School of Medicine

1-8-1 Inohana, Chuo-ku, Chiba, Japan

Email: mine_s@faculty.chiba-u.jp