Intestinal type adenocarcinoma of the ethmoid: Outcomes of a treatment regimen based on endoscopic surgery with or without radiotherapy

Head Neck. 2016 Apr:38 Suppl 1:E996-E1003. doi: 10.1002/hed.24144. Epub 2015 Sep 4.

Abstract

Background: The purpose of this study was to assess survival, prognostic factors, and complications in a cohort of patients with intestinal-type adenocarcinoma (ITAC) treated with transnasal endoscopic surgery ± radiotherapy (RT).

Methods: Patients with ITAC who underwent endoscopic surgery ± RT at 2 tertiary centers were retrospectively reviewed. Overall survival (OS) and event-free survival were calculated, and statistically significant variables were entered in a multivariate Cox regression model. Complications were also analyzed.

Results: One hundred-sixty-nine patients were included. Major complications occurred in 9.5% of patients. Adjuvant RT was delivered in 58.6% of patients. Five-year OS and event-free survival were 68.9% and 63.6%, respectively. Advanced pT classification, high-grade, and positive surgical margins were independently predictive of poor survival.

Conclusion: Endoscopic surgery ± RT is a valid treatment option in most cases of ITAC. When compared with series based on external surgery, our results support a definitive paradigm shift in the management of ITAC. © 2015 Wiley Periodicals, Inc. Head Neck 38: E996-E1003, 2016.

Keywords: endoscopic surgery; endoscopy; ethmoid; intestinal-type adenocarcinoma; sinonasal tumors.

MeSH terms

  • Adenocarcinoma / therapy*
  • Aged
  • Disease-Free Survival
  • Endoscopy*
  • Ethmoid Sinus / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nose Neoplasms / therapy*
  • Radiotherapy, Adjuvant*
  • Retrospective Studies