Paranasal Sinus Cancer

Abstract

AbstractMalignant disease arising in the maxillary, ethmoid, frontal, or sphenoid sinuses, collectively known as the paranasal sinuses, is rare. Paranasal sinus cancer represents less than 5% of all head and neck malignancy, which in turn comprises less than 10% of malignancy overall. The majority of paranasal sinus cancers arise within the maxillary sinus (70–80%) followed by the ethmoid sinus (10–20%). Because of this, much of the literature (including the present chapter) focuses on data derived from description of tumors arising at these two sites. Cancers arising in the sphenoid or frontal sinuses are extremely rare. The outcome of patients presenting with paranasal sinus cancer is generally poor, with most centers reporting 5‐year survival rates in the range of 30–40%.As with any rare disease, the task of reliably identifying and validating independent prognostic factors for paranasal sinus cancer is complicated by the lack of prospectively collected data and the variability of data reported in the retrospective literature that spans many decades, with most series containing relatively small numbers of patients. Reports frequently describe patients with a wide range of tumor extent and histology treated with variable treatment approaches. Outcomes are often analyzed and reported with respect to different endpoints. Prognostication and empiric management recommendations are regularly based on conclusions drawn from the comparison of inhomogeneous treatment groups. In this chapter we attempt to identify prognostic factors that are supported by currently available data and, of equal importance, those that do not enjoy this support.