Abstract：
OBJECTIVE: Sinonasal malignant tumors (SNMT) are relatively rare among head and neck malignant tumors. Most are squamous cell carcinomas, and malignant melanomas, olfactory neuroblastomas, adenoid cystic carcinomas, sarcomas, and others also occur. The most common primary site of nasal sinus squamous cell carcinoma is the maxillary sinus. In recent years, a decrease in incidence of maxillary sinus squamous cell carcinoma (MSSCC) has been reported along with a decrease in the incidence of sinusitis. MSSCC is treated with a combination of surgery, radiation, and chemotherapy. Treatment decisions are made according to the progression of the disease, the patient\'s general condition, and the patient\'s own wishes. There are variations in treatment policies among facilities due to the specialty of staff and cooperation with other departments at each facility. We conducted a multi-institutional retrospective study to compare outcomes by treatment strategy.
METHODS: In this study, 340 patients with SNMT who were treated at 13 Hospitals (Head and Neck Oncology Group (Kyoto-HNOG) ) during the 12-year period from January 2006 to December 2017 were included. There were 220 patients with squamous cell carcinoma, 32 with malignant melanoma, 21 with olfactory neuroblastoma, and 67 with other malignancies. Of the squamous cell carcinomas, 164 were of maxillary sinus origin. One hundred and forty cases of MSSCC that were treated radically were included in the detailed statistical analysis.
RESULTS: There were 5 cases of cStage I, 9 cases of cStage II, 36 cases of cStage III, 74 cases of cStage IVa, and 16 cases of cStage IVb. There were 92 cases without clinical lymph node metastasis (cN(-)) and 48 cases with clinical lymph node metastasis(cN(+)). Primary tumors were treated mainly by surgery in 85 cases (Surg) and by radical radiation therapy (with or without chemotherapy) of 6-70 Gy in 55 cases(non-Surg). The 5-year overall/disease-free survival rate (OS/DFS) for MSSCC was 65.1%/51.6%. Old age, renal dysfunction, and clinical T progression were independent risk factors for OS, and renal dysfunction was an independent risk factor for DFS. In cN(-) patients, OS and DFS were significantly better in Surg group than in non-Surg group. In cN(+) patients, there was no significant difference in OS and DFS between Surg and non-Surg groups.
CONCLUSIONS: For patients with MSSCC without lymph node metastasis, aggressive surgery on the primary tumor contributes to improved prognosis.
METHODS: In this study, 340 patients with SNMT who were treated at 13 Hospitals (Head and Neck Oncology Group (Kyoto-HNOG) ) during the 12-year period from January 2006 to December 2017 were included. There were 220 patients with squamous cell carcinoma, 32 with malignant melanoma, 21 with olfactory neuroblastoma, and 67 with other malignancies. Of the squamous cell carcinomas, 164 were of maxillary sinus origin. One hundred and forty cases of MSSCC that were treated radically were included in the detailed statistical analysis.
RESULTS: There were 5 cases of cStage I, 9 cases of cStage II, 36 cases of cStage III, 74 cases of cStage IVa, and 16 cases of cStage IVb. There were 92 cases without clinical lymph node metastasis (cN(-)) and 48 cases with clinical lymph node metastasis(cN(+)). Primary tumors were treated mainly by surgery in 85 cases (Surg) and by radical radiation therapy (with or without chemotherapy) of 6-70 Gy in 55 cases(non-Surg). The 5-year overall/disease-free survival rate (OS/DFS) for MSSCC was 65.1%/51.6%. Old age, renal dysfunction, and clinical T progression were independent risk factors for OS, and renal dysfunction was an independent risk factor for DFS. In cN(-) patients, OS and DFS were significantly better in Surg group than in non-Surg group. In cN(+) patients, there was no significant difference in OS and DFS between Surg and non-Surg groups.
CONCLUSIONS: For patients with MSSCC without lymph node metastasis, aggressive surgery on the primary tumor contributes to improved prognosis.
摘要：
目的：鼻窦恶性肿瘤（SNMT）在头颈部恶性肿瘤中相对少见。大多数是鳞状细胞癌，恶性黑色素瘤，嗅觉神经母细胞瘤,腺样囊性癌，肉瘤,其他人也发生了。鼻窦鳞状细胞癌最常见的原发部位是上颌窦。近年来,据报道,上颌窦鳞状细胞癌(MSSCC)的发病率下降,同时鼻窦炎的发病率下降.MSSCC采用联合手术治疗，辐射,和化疗。根据疾病的进展做出治疗决定，病人的一般情况，和病人自己的愿望。由于工作人员的特殊性以及每个设施与其他部门的合作，设施之间的治疗政策有所不同。我们进行了一项多机构回顾性研究，以比较治疗策略的结果。
方法：在本研究中，纳入了从2006年1月至2017年12月在13家医院（头颈部肿瘤组（Kyoto-HNOG））接受治疗的340名SNMT患者。有220例鳞状细胞癌患者，32患有恶性黑色素瘤，21患有嗅神经母细胞瘤，67与其他恶性肿瘤。鳞状细胞癌，164个为上颌窦起源。在详细的统计分析中纳入了接受根治性治疗的240例MSSCC。
结果：有5例cStageI，9例cStageII，36例CⅢ期，74例cStageIVa，16例c期IVb。92例无临床淋巴结转移(cN(-)),48例有临床淋巴结转移(cN(+))。85例（Surg）主要通过手术治疗原发性肿瘤，55例（非Surg）主要通过6-70Gy的根治性放疗（有或没有化疗）治疗。MSSCC的5年总体/无病生存率(OS/DFS)为65.1%/51.6%。老年,肾功能不全,临床T进展是OS的独立危险因素，肾功能不全是DFS的独立危险因素。在cN(-)患者中，Surg组的OS和DFS明显优于非Surg组。在cN(+)患者中，Surg和非Surg组之间的OS和DFS没有显着差异。
结论：对于无淋巴结转移的MSSCC患者，对原发肿瘤进行积极的手术有助于改善预后。
方法：在本研究中，纳入了从2006年1月至2017年12月在13家医院（头颈部肿瘤组（Kyoto-HNOG））接受治疗的340名SNMT患者。有220例鳞状细胞癌患者，32患有恶性黑色素瘤，21患有嗅神经母细胞瘤，67与其他恶性肿瘤。鳞状细胞癌，164个为上颌窦起源。在详细的统计分析中纳入了接受根治性治疗的240例MSSCC。
结果：有5例cStageI，9例cStageII，36例CⅢ期，74例cStageIVa，16例c期IVb。92例无临床淋巴结转移(cN(-)),48例有临床淋巴结转移(cN(+))。85例（Surg）主要通过手术治疗原发性肿瘤，55例（非Surg）主要通过6-70Gy的根治性放疗（有或没有化疗）治疗。MSSCC的5年总体/无病生存率(OS/DFS)为65.1%/51.6%。老年,肾功能不全,临床T进展是OS的独立危险因素，肾功能不全是DFS的独立危险因素。在cN(-)患者中，Surg组的OS和DFS明显优于非Surg组。在cN(+)患者中，Surg和非Surg组之间的OS和DFS没有显着差异。
结论：对于无淋巴结转移的MSSCC患者，对原发肿瘤进行积极的手术有助于改善预后。
