Single modality and multimodality treatment of nasal and paranasal sinuses cancer: A single institution experience of 229 patients

Aims To assess the single and multimodal treatment results and prognostic factors for sinonasal carcinoma. Methods Overall survival (OS), disease-specific survival (DSS), local control (LC), and disease-free survival (DFS) in 229 patients with sinonasal carcinoma treated from 1967 to 2003 were calculated. Prognostic factors were univariately and multivariately analyzed. The median follow-up period for survivors was 126 months. Results 32% of the patients were operated only, 47% underwent multimodal therapy, and 20% were treated without operation. The 5-year OS rate was 41%, and the DSS rate was 51%. The LC rate was 64%, and the DFS rate was 34%. Prognostic for DSS were M status (p < 0.001), UICC stage (p < 0.001), T classification (p = 0.001), N status (p = 0.002), intracranial tumor infiltration (p = 0.008), infiltration of the pterygopalatine fossa (p = 0.02), infiltration of the skull base (p = 0.021), infiltration of the orbita (p = 0.041), and the type of therapy (p < 0.001): The 5-year DSS rate was 63% for patients operated only, 56% for all operated patients, 46% for patients undergoing surgery and radiotherapy, but only 21% for patients treated with radiotherapy ± chemotherapy. Multivariate analysis revealed that T classification (p = 0.042), N classification (p = 0.035), M classification (p = 0.007), UICC stage (p = 0.038), and type of therapy (p = 0.038) were independent prognostic factors for DSS. Conclusions Radical surgery is recommended for stage I/II sinonasal carcinomas. Stage III/IV carcinomas still have a poor prognosis, but multimodal treatment seems to favor the outcome.