Squamous Cell Carcinoma Of Paranasal Sinuses Research Articles

PP183 MRI radiomics may predict early tumor recurrence in patients with paranasal sinus squamous cell carcinoma

PP183 MRI radiomics may predict early tumor recurrence in patients with paranasal sinus squamous cell carcinoma

The value of preoperative radiotherapy in the treatment of locally advanced nasal cavity and paranasal sinus squamous cell carcinoma: A single institutional experience

ObjectivesThis study aimed to explore the value of preoperative radiotherapy in the comprehensive treatment of locally advanced nasal cavity and paranasal sinus squamous cell carcinomas (LA-NPSCCs). MaterialsThis retrospective study included 140 patients with stage III-IVB NPSCCs treated with pre-/postoperative radiotherapy plus surgery. The complete resection rate, pathologic complete response (pCR) rate, and orbital content retention rate were calculated. The overall survival (OS), local control (LC), distance metastasis free survival (DMFS) and disease-free survival (DFS) between treatment groups were evaluated. ResultsWith a median follow-up of 92.3 months, the 5-year OS, LC, DMFS, and DFS of entire cohort were 62.0%, 65.5%, 85.4%, and 57.8%, respectively. The preoperative radiotherapy group achieved similar LC, DFS, DMFS, and OS rates compared to postoperative radiotherapy group, despite higher rates of stage IV and orbital content/apex invasion. The preoperative radiotherapy resulted in significantly improved complete resection rate (93.3% vs 38.0%, p < 0.001). In the preoperative radiotherapy group, one third of patients achieved pathologic complete response. The pCR subgroup achieved statistically higher 5-year OS, LC, DFS (p < 0.05), but similar 5-year DMFS (p > 0.05) compared to non-pCR subgroup. The actual orbital content retention rate in preoperative radiotherapy group was 85.7%, superior to 58.3% in postoperative radiotherapy group (p = 0.049). ConclusionOn the basis of multimodality therapy becoming standard paradigm for LA-NPSCCs, preoperative radiotherapy significantly improved complete resection rate and orbital content retention rate. Therefore, preoperative radiotherapy followed by surgery might be desirable for LA-NPSCCs, especially for those with organ preservation intention.

The Value of Preoperative Radiotherapy in the Treatment of Locally Advanced Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma: A Single Institutional Experience

The value of preoperative radiotherapy in the comprehensive treatment of locally advanced nasal cavity and paranasal sinus squamous cell carcinomas (NPSCCs) remains controversial. The aim of our study was to compare the efficacy of preoperative and postoperative radiotherapy and further to explore the value of preoperative radiotherapy in the treatment of locally advanced NPSCCs. One hundred and forty-two patients with locally advanced NPSCCs treated with pre- / postoperative radiotherapy plus surgery from our institution between January 1998 and December 2014 were retrospectively reviewed. All enrolled patients were divided into the two groups: preoperative radiotherapy (Pre-S RT) group and postoperative radiotherapy (PORT) group. The overall survival (OS), local control (LC), distance metastasis free survival (DMFS) and disease-free survival (DFS) between treatment groups were evaluated. A higher proportion of adverse prognostic factors, such as orbital content invasion, low RT dose, and 2D/3DCRT were found in preoperative radiotherapy group, which were confirmed to be associated with overall survival and/or local control by univariate and multivariate analysis. The median radiation dose of preoperative and postoperative radiotherapy was 60Gy and 69Gy (P value < 0.001). At a median follow-up of 49 months, preoperative radiotherapy achieved good LC, DFS, DMFS, and OS, not worse than postoperative radiotherapy. The 5-year OS, LC, DMFS, and DFS of Pre-S RT group were 55.1%, 59.1%, 78.7%, and 49.0%, while those of PORT group were 52.2%, 60.0%, 76.6%, and 47.3%, respectively (P value > 0.05). After preoperative radiotherapy, the complete resection rate reached 93.5%, significantly higher than 31.2% in the postoperative radiotherapy group (P value <0.001). Among the 50 patients with orbital contents invasion, the actual orbital content preservation rate of preoperative radiotherapy group was nearly 76%, higher than that of postoperative radiotherapy group (57%). The pathologic complete response (pCR) rate of the preoperative radiotherapy group was up to 30.6%. Compared with non-pCR group, pCR group had significantly higher 5-year OS, LC, DFS (P value < 0.05), and similar 5-year DMFS (P value > 0.05). In the absence of randomized controlled studies to guide treatment, this study confirmed the value of preoperative radiotherapy. Under the condition of more adverse factors, preoperative radiotherapy plus surgery not only achieved similar clinical outcomes to surgery plus postoperative radiotherapy, but also significantly improved complete resection rate and increased the chance of orbital contents preservation. More importantly, nearly a third of patients achieved pCR in the preoperative radiotherapy group, and this subgroup had the best prognosis.

Prognostic Factors in Paranasal Sinus Squamous Cell Carcinoma and Adenocarcinoma: A SEER Database Analysis.

Background Outcome studies on sinonasal malignancy are limited to retrospective case series, often with inclusion of diverse histology and short follow-up. The objective of this study was to identify key predictive variables that independently impact survival for paranasal sinus squamous cell carcinoma (SCC) and adenocarcinoma (AC) and to compare these variables in the context of these two distinct clinicopathologic entities. Methods: Analysis was conducted using the Surveillance, Epidemiology, and End Results database from 1973 to 2012 to identify key variables that impact survival for SCC and AC. Results A total of 3,714 cases were included. There were 2,895 SCC cases and 819 AC cases. The mean age at diagnosis was 64.1 years. The male to female ratio for SCC and AC was 1.85 and 1.04, respectively. Patients with SCC and AC were most often diagnosed with stage IV disease in 61.8 and 63.4% of cases, respectively. The majority of patients received combined surgery and radiation (52% for SCC and 43.1% for AC). For SCC, increased age ( p < 0.001) and stage ( p < 0.001) were negative predictors, and surgery improved survival ( p < 0.001) on multivariate analysis. For AC, prognostic factors associated with worse survival include increased age ( p < 0.001) and grade ( p < 0.001) on multivariate analysis. Overall survival was significantly higher in AC compared with SCC at 5 years ( p = 0.001). Conclusion SCC and AC of the paranasal sinuses are both aggressive malignancies with poor survival. For both histological subtypes, increased age predicts worse survival and grade also closely links to survival in AC. These data have important potential implications for treatment planning and pretreatment counseling.

Paranasal sinus squamous cell carcinoma incidence and survival based on Surveillance, Epidemiology, and End Results data, 1973 to 2009

Paranasal sinus squamous cell carcinomas (PNSSCC) account for 3% of all head and neck malignancies. There has been little information on the trends in incidence and survival, and no randomized trials have been conducted to guide therapy. Patients with PNSSCC reported to the Surveillance, Epidemiology, and End Results (SEER) Program from 1973 through 2009 were categorized by sex, age, year of diagnosis, primary site, stage, and treatment. The incidence and survival were then compared across different demographic and disease-related categories by calculating rate ratios (RRs) and mortality hazard ratios along with the corresponding 95% confidence intervals (CIs). In total, 2553 patients with PNSSCC were identified. While incidence of PNSSCC showed a gradual decline, survival remained largely unchanged. The proportion of patients with advanced disease decreased from 14.7% during the period from 1983 to 1992 to 12.4% during 1993-2002 and to 9.5% during 2003-2009. Compared with whites, incidence was higher among African Americans (RR 1.63; 95% CI, 1.39, 1.90) and among all other racial groups (RR, 1.78; 95% CI: 1.53-2.07). After adjusting for age, sex, disease stage, tumor site, and treatment, mortality among African American patients also was increased (hazard ratio, 1.22; 95% CI, 1.04-1.43). Among patients with localized disease, the relation between race and mortality was no longer evident once the results were controlled for tumor classification. The current findings point to racial disparities in the incidence of PNSSCC and, to a lesser extent, in the outcome of patients with PNSSCC. Although there has been a decline in the proportion of patients presenting with advanced PNSSCC, the overall survival remained stable over time.

Management of Hemorrhagic Pseudoaneurysmal Arteriovenous Fistula of the Sphenopalatine Artery

n-Butyl cyanoacrylate (n-BCA) embolization of a hemorrhagic pseudoaneurysmal arteriovenous fistula of the sphenopalatine artery in a patient with paranasal sinus squamous cell carcinoma treated with regional surgery and radiation has, to our knowledge, not been previously reported.

Evaluation of P53, P63, P21, P27, Ki-67 in Paranasal Sinus Squamous Cell Carcinoma and Inverted Papilloma

Using a molecular genetic approach, we try to confirm the molecular alterations of inverted papilloma and clarify its status as a putative precursor lesion of sinonasal squamous cell carcinoma. To better understand its genetics, we investigated the immunohistochemical protein expression patterns of cell-cycle-regulators p53, p63, p21, p27 and proliferation marker Ki-67 in 22 inverted papilloma and 9 squamous cell carcinoma of the sinonasal tract. Significantly elevated levels of p53 and p63 in squamous cell carcinoma of sinonasal tract compared with inverted papilloma were revealed. Ki-67-stained neoplastic cell nuclei were found in a significantly higher percentage of squamous cell carcinoma of sinonasal tract than in inverted papilloma, whereas no variation of p21 and p27 expression was identified. This work first examined the immunohistochemical overexpression of p63 in sinonasal inverted papilloma and squamous cell carcinoma. In conclusion, this is a first study shedding light on the expression of p63 in tumors of paranasal sinuses.

Horner Syndrome and Abducens Nerve Paresis Due to a Paranasal Sinus Squamous Cell Carcinoma Involving Cavernous Sinus

Horner Syndrome and Abducens Nerve Paresis Due to a Paranasal Sinus Squamous Cell Carcinoma Involving Cavernous Sinus

Outcomes of dacrocystorhinostomy in patients with head and neck tumors

5584 Background: To evaluate the outcomes of dacryocystorhinostomy (DCR) in patients with head and neck tumors. Methods: The clinical records of all 31 patients with head and neck tumors who underwent DCR for nasolacrimal duct blockage at M.D. Anderson Cancer Center between 1999 and 2003 were retrospectively reviewed for outcome and complications of DCR. Results: Nasolacrimal duct blockage was diagnosed in 35 eyes of 31 patients. The tumor diagnoses were as follows: squamous cell carcinoma (SCCA), 18 patients (16 had paranasal-sinus SCCA and 2 had skin SCCA); chondrosarcoma, 3; sinonasal carcinoma, 2; adenoid cystic carcinoma, 2; sinonasal papilloma, 2; esthesioneuroblastoma, 1; hemangiopericytoma,1; ameloblastoma,1; and ostoesarcoma,1. Twenty-one patients had a maxillectomy and 7 patients had other sinus surgeries before DCR. Six patients had had silicone intubation at the time of maxillectomy but later developed epiphora and nasolacrimal duct blockage. Ten patients had radiotherapy and 14 had chemotherapy and radiotherapy before DCR. The mean time between completion of radiotherapy and DCR was 24 months (median, 31.5 months), and the mean time between completion of chemotherapy and DCR was 21.5 months (median, 12.5 months). All 31 patients (35 eyes) experienced improvement of epiphora after DCR, but in 4 patients (4 eyes), epiphora recurred during the study period. Probing and irrigation in these 4 patients revealed recurrent nasolacrimal duct blockage. In 1 of these 4 patients, tumor recurrence in the nasal cavity was the cause; he subsequently underwent a total rhinectomy. In another patient, recurrent blockage was due to extrusion of the Pyrex glass tube, which was later replaced. The other 2 patients with recurrent blockage elected not to have additional surgery. None of the patients who had had radiotherapy developed osteoradionecrosis. Two patients had mild wound infections, which resolved after 1 week of systemic antibiotic therapy. Conclusions: DCR alleviates nasolacrimal duct blockage in the majority of patients with head and neck tumors with this side effect. No significant financial relationships to disclose.