Maxillary sinus squamous cell carcinoma

上颌窦鳞状细胞癌
  • 文章类型: Journal Article
    我们的目的是研究选择性颈淋巴结清扫术(END)对cT2N0上颌窦鳞状细胞癌(MS-SCC)患者预后的影响,并确定预测该患者人群隐匿性转移发生的因素。使用来自SEER数据库的数据进行回顾性分析。cT2N0MS-SCC患者被纳入研究,并分为两组:接受END的患者和未接受END的患者。使用倾向评分匹配评估END对疾病特异性存活(DSS)和总存活(OS)的影响。进行多因素logistic回归分析以确定隐匿性转移的预测因素。共有180名患者被纳入研究,40例收尾。在倾向得分匹配之后,接受END治疗的患者和未接受END治疗的患者的DSS和OS发生率相似.9例患者出现隐匿性转移,相当于22.5%的比率。与低级别肿瘤相比,高级别肿瘤与隐匿性转移的风险更高(风险比1.52,95%置信区间1.17-2.00)。CT2MS-SCC具有22.5%的隐匿性转移率,组织学分级是隐匿性转移的主要决定因素。END在该患者群体中不赋予显著的生存益处。
    Our objective was to examine the impact of elective neck dissection (END) on the prognosis of patients with cT2N0 maxillary sinus squamous cell carcinoma (MS-SCC) and to determine factors that predict the occurrence of occult metastasis in this patient population. A retrospective analysis was conducted using data from the SEER database. Patients with cT2N0 MS-SCC were included in the study and divided into two groups: those who received END and those who did not. The impact of END on disease-specific survival (DSS) and overall survival (OS) was assessed using propensity score matching. Multivariate logistic regression analysis was performed to determine predictors for occult metastasis. A total of 180 patients were included in the study, with 40 cases receiving END. Following propensity score matching, patients treated with END and those without showed similar DSS and OS rates. Occult metastasis was observed in 9 patients, corresponding to a rate of 22.5%. High-grade tumors were independently associated with a higher risk of occult metastasis compared to low-grade tumors (hazard ratio 1.52, 95% confidence interval 1.17-2.00). cT2 MS-SCC carries an occult metastasis rate of 22.5%, with histologic grade being the primary determinant of occult metastasis. END does not confer a significant survival benefit in this patient population.
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  • 文章类型: Journal Article
    背景:上颌窦鳞状细胞癌(MS-SCC)是一种罕见的恶性肿瘤,确定cT3/4N0MS-SCC患者的最佳颈部管理方法仍然是一个正在进行辩论的话题。这项研究的目的是比较cT3/4N0MS-SCC接受选择性颈淋巴结清扫术(END)或选择性颈照射(ENI)的患者的预后和生活质量。
    方法:在这项回顾性研究中,我们招募了接受手术治疗的cT3/4N0MS-SCC患者,使用倾向评分匹配比较了不同颈部管理策略对区域控制和疾病特异性生存率的影响.使用Mann-WhitneyU检验评估手术干预对生活质量的影响。
    结果:在纳入的120例患者中,36结束。在倾向得分匹配后,我们的分析表明END没有导致优于ENI的结果,区域控制率(p=0.990)和疾病特异性生存率(p=0.999)证明了这一点。然而,在70份退回的问卷中,接受END的患者报告在外观领域得分较高,咀嚼,和言语比接受ENI的患者。
    结论:我们的研究结果表明,尽管END和ENI有助于相似的预后,END产生优越的功能结果。
    BACKGROUND: Maxillary sinus squamous cell carcinoma (MS-SCC) is an infrequent malignancy, and determining the optimal neck management for patients with cT3/4N0 MS-SCC remains a topic of ongoing debate. The purpose of this study was to compare the prognoses and quality of life outcomes of patients who underwent either elective neck dissection (END) or elective neck irradiation (ENI) for cT3/4N0 MS-SCC.
    METHODS: In this retrospective study, we enrolled patients with surgically treated cT3/4N0 MS-SCC, and the impact of different neck management strategies on regional control and disease-specific survival was compared using propensity score matching. The effect of surgical intervention on quality of life was evaluated using the Mann-Whitney U test.
    RESULTS: Of the 120 patients included, 36 underwent END. After propensity score matching, our analysis indicated that END did not lead to superior outcomes than ENI, as demonstrated by comparable rates of regional control (p = 0.990) and disease-specific survival (p = 0.999). However, in the 70 returned questionnaires, patients who underwent END reported higher scores in the domains of appearance, chewing, and speech than did patients who underwent ENI.
    CONCLUSIONS: Our findings suggest that while END and ENI contribute to similar prognoses, END yields superior functional outcomes.
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  • 文章类型: Journal Article
    背景:上颌窦鳞状细胞癌(MSSCC)是一种相对罕见的头颈部癌,预后不明确,本研究旨在探讨不同治疗方法对MSSCC的治疗效果。
    方法:回顾性分析2007-2017年天津医科大学肿瘤医院病理数据库,收集98例经病理证实的MSSCC患者。对每位患者进行回顾性分析和随访。采用Cox回归模型对预后因素进行多因素分析。
    结果:对于所有98例MSSCC,5年总生存率(OS)和无病生存率(DFS)分别为31.0%和29.3%,分别。在98名患者中,33例患者接受了全身治疗(NON-SUR),19例患者接受新辅助化疗和/或放疗,然后手术(CT/RT+SUR),38例患者接受手术,然后化疗和/或放疗(SUR+RT/CT),8例患者单独进行手术(SUR)。各组OS率为27.3%,57.9%,30.6%和37.5%,分别,而DFS为21.2%,36.8%,31.6%和25.0%,分别。CT/RT+SUR组的OS率明显高于NON-SUR组和SUR+CT/RT组(P<0.05)。多变量分析表明,吸烟,低分化,晚期T分期是OS的独立危险因素,而DFS的低分化和晚期N期。
    结论:基于手术的治疗仍然是MSSCC的一线治疗策略。对于MSSCC患者,强烈推荐新辅助放化疗后再手术,尤其是那些患有晚期肿瘤或要求高质量生活的患者。
    BACKGROUND: Maxillary sinus squamous cell carcinoma (MSSCC) is a relatively rare head and neck cancer with poorly defined prognosis, and the present study aimed to investigate the outcomes for MSSCC according to different treatments.
    METHODS: Tianjin Medical University Cancer Institute and Hospital pathology database was reviewed from 2007 to 2017, and 98 patients with pathologically confirmed MSSCC were enrolled. Retrospective analysis and follow-up were performed for each patient. Multivariate analysis of prognostic factors was performed using Cox\'s regression model.
    RESULTS: For all the 98 cases of MSSCC, the 5-year overall survival (OS) and disease-free survival (DFS) rates were 31.0% and 29.3%, respectively. Among 98 patient, 33 patients were treated with systemic treatment (NON-SUR), 19 patients underwent neoadjuvant chemotherapy and/or radiotherapy followed by surgery (CT/RT+SUR), 38 patients received surgery followed by chemotherapy and/or radiotherapy (SUR+RT/CT), and 8 patients were performed surgery alone (SUR).The OS rate for each group was 27.3%, 57.9%, 30.6% and 37.5%, respectively, while the DFS was 21.2%, 36.8%, 31.6% and 25.0%, respectively. The OS rate of CT/RT+SUR was significantly higher than that of NON-SUR and SUR+CT/RT groups (P < 0.05). Multivariate analysis revealed that smoking, low differentiation, and advanced T stage were independent risk factors for OS, while low differentiation and advanced N stage for DFS.
    CONCLUSIONS: Surgery-based treatment is still the first-line therapeutic strategy for MSSCC. And neoadjuvant chemoradiotherapy followed by surgery is highly recommended for MSSCC patients, especially those with advanced tumors or requesting high quality of life.
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  • 文章类型: Journal Article
    The albumin:globulin (A:G) ratio, adult comorbidity evaluation 27 (ACE-27), and TMN staging have been shown to be strong predictive indicators of the survival of patients with many types of tumours. We have investigated the prognostic value of pretreatment based on the A:G ratio combined with TMN staging and ACE-27 in patients with squamous cell carcinoma (SCC) of the maxillary sinus. We studied 196 patients, and the prognostic value was explored by univariate and multivariate Cox\'s hazards analysis. Multivariate analyses suggested that pretreatment A:G ratio was independently associated with overall survival (hazard ratio (HR) 1.542, 95% CI 1.219 to 1.991, p=0.002); disease-specific survival, (HR 1.499, 95% CI 1.197 to 1.842, p=0.001); and disease-free survival (HR 1.452, 95% CI 1.207 to 1.834, p<0.001). Additional prognostic factors shown in the survival analyses included ACE-27, pathological T stage, and pathological N stage. Pretreatment A:G ratio combined with ACE-27 and TMN staging were powerful prognostic indicators of outcome in patients with SCC of the maxillary sinus, which has potentially important ramifications for stratification of the disease in the future.
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  • 文章类型: Journal Article
    目的:评估上颌窦鳞状细胞癌(MS-SCC)超选择性动脉内放化疗(RADPLAT)的疗效和预后因素。
    方法:年龄的预后意义,性别,T和N因子,原发部位的总肿瘤体积(GTV),顺铂总剂量,分析每个GTV(CDDP/GTV)的总顺铂剂量对原发部位无复发生存率(PRFS)的影响。对27例患者给予RADPLAT。中位随访期为42.1个月。
    结果:3年总生存率和PRFS分别为59.2%和53.9%,分别。在单变量分析中,年龄,男性,顺铂总用量是影响PRFS的重要因素。在多变量分析中,淋巴结转移是PRFS的重要因素,性别和总顺铂剂量对PRFS的影响较弱。在急性期,无患者出现≥3级血液学毒性,5例患者出现3级粘膜炎。在3例患者中发现了晚期毒性(面部2级痰,3级颌面部骨坏死,和视网膜病变)。12例(44%)患者复发。其中,8例患者在原发灶复发。
    结论:RADPLAT对MS-SCC有效,具有可接受的毒性。建议顺铂的总剂量对于原发性肿瘤控制很重要。
    OBJECTIVE: To assess the efficacy and prognostic factors after superselective intra-arterial chemoradiation (RADPLAT) for maxillary sinus squamous cell carcinoma (MS-SCC).
    METHODS: Prognostic significance of age, gender, T and N factors, gross tumor volume of the primary-site (GTV), total cisplatin dosage, and total cisplatin dosage per GTV (CDDP/GTV) for primary-site recurrence-free survival rate (PRFS) were analyzed. RADPLAT was administered to 27 patients. The median follow-up period was 42.1 months.
    RESULTS: The 3-year rates of overall survival and PRFS were 59.2% and 53.9%, respectively. In univariate analysis, age, male, and total cisplatin dosage were significant factors for PRFS. In multivariate analysis, lymph node metastasis was significant factors for PRFS, and gender and total cisplatin dosage weakly influenced PRFS. In acute phase, no patient showed ≥ grade 3 hematologic toxicity, and grade 3 mucositis developed in 5 patients. Late toxicities were recognized in 3 patients (grade 2 phlegmon of the face, grade 3 maxillofacial osteonecrosis, and retinopathy). Twelve patients (44%) experienced recurrences. Of them, 8 patients showed recurrence at the primarysite.
    CONCLUSIONS: RADPLAT was effective for MS-SCC, with acceptable toxicity. Total cisplatin dosage is suggested to be important for primary tumor control.
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  • 文章类型: Journal Article
    Paranasal sinus cancers are rare, aggressive tumours that are usually diagnosed at an advanced stage. They differ from other upper aerodigestive tract tumours in terms of risk factors (wood dust exposure) and premalignant lesions (inverted papillomas). The diagnosis should be suspected in the presence of unilateral and continuous nasal sinus symptoms or bone lysis or a heterogeneous opacity on imaging. The definitive positive diagnosis is based on histological examination. Staging must comprise face, brain, neck and chest CT as well as face and brain MRI. Tumours are stage T3-T4 in two-thirds of cases and are associated with cervical lymph node involvement in 10% of squamous cell carcinomas and 4% of adenocarcinomas. These tumours must be managed in reference centres experienced in all of the various treatment modalities. Treatment decisions must be based on a multidisciplinary approach comprising local, regional and national REFCOR expertise (French rare head and neck cancer network). Optimal treatment is surgical resection with clear margins associated with adjuvant intensity-modulated radiotherapy (IMRT). Although it has been improved over recent decades, the prognosis remains poor with local recurrences occurring in 38% of cases and a five-year overall survival of about 63%.
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