Abstract：
OBJECTIVE: Sinonasal adenocarcinomas are rare and heterogeneous tumors and for this reason remain understudied. Our purpose is to analyze clinical presentation, outcomes and factors affecting survival of patients with sinonasal adenocarcinomas, treated at our institution.
METHODS: Retrospective review of clinical records of patients with sinonasal adenocarcinoma, treated at a tertiary oncology institution (January 2010 to December 2019).
RESULTS: Sixty patients diagnosed with adenocarcinoma were included, with male preponderance (54.90%) and a mean age of 57.5±14.9 years. Adenocarcinoma was the most frequent type of sinonasal cancer, contrary to previous reports from our institution. In most patients, it was detected at an advanced disease stage, significantly decreasing their survival rate when compared to patients diagnosed at initial stages (p<0.029). Intestinal type adenocarcinoma was established in 47 patients, the most frequent being the colonic subtype (24%). Tumors with good/moderate histologic differentiation presented a survival advantage over those that were poorly differentiated (p=0.043). The most common treatment modality was surgery followed by radiotherapy. Endoscopic resection was performed in 53% of the patients and an external approach was used in 40% of the patients. Estimated overall survival rates at 3 and 5-years were 64% and 53%, respectively, and cancer specific survival 72% and 65%, for the same period. Recurrence rate was 32% and occurred mainly locally. Disease Free Survival rate was 71% at 3 years and 65% at 5 years.
CONCLUSIONS: Despite being the most common sinonasal malignancy in our sample, in contrast to other series, sinonasal adenocarcinomas are still rare tumors with a substantial local failure rate of around 30%. Advanced stage at diagnosis and histologic differentiation grade negatively affected prognosis of these tumors.
METHODS: Retrospective review of clinical records of patients with sinonasal adenocarcinoma, treated at a tertiary oncology institution (January 2010 to December 2019).
RESULTS: Sixty patients diagnosed with adenocarcinoma were included, with male preponderance (54.90%) and a mean age of 57.5±14.9 years. Adenocarcinoma was the most frequent type of sinonasal cancer, contrary to previous reports from our institution. In most patients, it was detected at an advanced disease stage, significantly decreasing their survival rate when compared to patients diagnosed at initial stages (p<0.029). Intestinal type adenocarcinoma was established in 47 patients, the most frequent being the colonic subtype (24%). Tumors with good/moderate histologic differentiation presented a survival advantage over those that were poorly differentiated (p=0.043). The most common treatment modality was surgery followed by radiotherapy. Endoscopic resection was performed in 53% of the patients and an external approach was used in 40% of the patients. Estimated overall survival rates at 3 and 5-years were 64% and 53%, respectively, and cancer specific survival 72% and 65%, for the same period. Recurrence rate was 32% and occurred mainly locally. Disease Free Survival rate was 71% at 3 years and 65% at 5 years.
CONCLUSIONS: Despite being the most common sinonasal malignancy in our sample, in contrast to other series, sinonasal adenocarcinomas are still rare tumors with a substantial local failure rate of around 30%. Advanced stage at diagnosis and histologic differentiation grade negatively affected prognosis of these tumors.
摘要：
目的：鼻窦腺癌是罕见且异质性的肿瘤，因此仍未得到充分研究。我们的目的是分析临床表现，影响鼻窦腺癌患者生存的结果和因素，在我们的机构治疗。
方法：回顾鼻窦腺癌患者的临床记录，在三级肿瘤学机构接受治疗（2010年1月至2019年12月）。
结果：纳入60例腺癌患者，男性优势（54.90％），平均年龄为57.5±14.9岁。腺癌是最常见的鼻窦肿瘤类型,与我们机构以前的报道相反。在大多数患者中，它是在疾病晚期发现的，与初始阶段诊断的患者相比，其生存率显着降低（p<0.029）。肠型腺癌47例，最常见的是结肠亚型(24%)。具有良好/中等组织学分化的肿瘤相对于低分化的肿瘤具有生存优势(p=0.043)。最常见的治疗方式是手术，然后是放疗。在53％的患者中进行了内窥镜切除，在40％的患者中使用了外部方法。估计3年和5年的总生存率分别为64％和53％，分别,癌症特异性生存率分别为72%和65%,在同一时期。复发率为32%，主要发生在局部。3年无病生存率为71％，5年为65％。
结论：尽管是我们样本中最常见的鼻窦恶性肿瘤，与其他系列相比，鼻窦腺癌仍然是罕见的肿瘤，其局部失败率约为30％。诊断晚期和组织学分化程度对这些肿瘤的预后有负面影响。
方法：回顾鼻窦腺癌患者的临床记录，
结果：纳入60例腺癌患者，
结论：尽管是我们样本中最常见的鼻窦恶性肿瘤，
