Review of Treatment Modalities for Maxillary Cancers-Institute’s Experience Over 10 Years.

Abstract

Objective : The treatment of squamous cell carcinoma of the maxilla and paranasal sinuses, radical surgery and reconstruction with free flaps is quoted in literature, but the protocol varies from center to centre. This study was performed to present our experience in the treatment of maxillary squamous cell carcinoma with surgery without reconstruction with post operative radiotherapy. Patients and Methods : Thirty patients with primary resectable squamous cell carcinoma were included in the study. The mean age was 65.6 years (20-80 years) and 53% presented in advanced tumor stage (T4). Two patients already had cervical metastases, underwent neck dissection. All patients were treated by radical surgery without reconstruction, and the resulting defects were closed primarily followed by the use of an obturator at 4-6 weeks. Results : The overall 5-year survival rate was 65.7%; the recurrence rate was 23.3%. Only patients who had stage T4 disease and positive resection margins, died during radiotherapy. The 2 patients with cervical metastases received therapeutic neck dissection and showed no regional recurrence. Conclusions : The surgical treatment without reconstruction and with postoperative radiotherapy for squamous cell carcinomas of the maxillary sinus led to good results, and can therefore be seen as a cost effective and valuable strategy. Free resection margins and early detection of the tumor are the most important factors for success. Our future focus is on orbital preservation & reconstruction of disfiguring defects following radical maxillectomy.