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J Neurol Surg B Skull Base 2020; 81(06): 627-637
DOI: 10.1055/s-0039-1694050
Original Article

Treatment of Sinonasal Adenocarcinoma: A Population-Based Prospective Cohort Study

Marton König 
1   Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
2   Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
,
Terje Osnes
2   Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
3   Department of Otorhinolaryngology, Head and Neck Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
,
Åse Bratland
4   Department of Oncology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
,
Peter Jebsen
5   Department of Pathology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
,
Torstein R. Meling
1   Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
2   Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
6   Service de Neurochirurgie, Département des Neurosciences Cliniques, Hopitaux Universitaires de Genève, Geneva, Switzerland
7   Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Abstract

Objectives Sinonasal adenocarcinoma (AC) is a potentially curable disease despite being an aggressive malignancy. Long-term survival can be achieved with early diagnosis and adequate multidisciplinary treatment. Our goal was to evaluate outcomes for patients with AC treated at our institution.

Design In a population-based consecutive prospective cohort, we conducted an analysis of all patients treated for surface epithelial AC between 1995 and 2018.

Results Twenty patients were included, and follow-up was 100%. The mean follow-up time was 89 months for the entire cohort (112 months for patients with no evidence of disease). Intestinal-type AC was found in 65%, whereas nonintestinal-type AC was found in 35% of all cases; 75% had stage T3/4 disease. Tumor grade was intermediate/high in 65%. Eighteen patients underwent treatment with curative intent (craniofacial resection [CFR] in 61%, transfacial approach in 39%, adjuvant radiotherapy in 89%), achieving negative margins in 56% of cases. Overall survival (OS) rates were 90, 68, and 54% after 2, 5, and 10 years of follow-up, respectively, and the corresponding disease-specific survival (DSS) rates were 90, 73, and 58%. Age over 60 years, tumor with a maxillary origin, and microscopic bone invasion were negative prognostic factors. Radical CFR was correlated with better OS and DSS.

Conclusion The high probability of achieving radicality with CFR, the low complication rate, the acceptable toxicity of modern irradiation modalities, and the promising survival rates indicate that this strategy might be considered a safe and an effective option for treating patients with very advanced sinonasal AC.

Keywords

Sinonasal Adenocarcinoma - craniofacial resection - adjuvant radiotherapy - survival

Ethical Approval

This study was approved by the data protection official at OUH (ePhorte 2015–5042). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study does not contain any studies with animals performed by any of the authors.


Informed Consent

For this type of study, formal consent is not required.




Publication History

Received: 06 February 2019

Accepted: 11 June 2019

Article published online:
30 July 2019

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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