Sinonasal Non-Intestinal-Type Adenocarcinoma: A Retrospective Review of 22 Patients

World Neurosurg. 2018 Dec:120:e962-e969. doi: 10.1016/j.wneu.2018.08.201. Epub 2018 Sep 6.

Abstract

Objective: To analyze outcomes and prognostic factors of sinonasal nonsalivary non-intestinal-type adenocarcinoma (n-ITAC.) METHODS: A retrospective review of 22 consecutive patients with n-ITAC was performed.

Results: Average follow-up time was 77 months. The 5-year overall survival and disease-specific survival were 95.2%. The 5-year overall survival and disease-specific survival were 100% for pT1, pT2, and pT3 tumors and 83.3% for pT4a and pT4b tumors; 100% for G1 tumors and 87.5% for G3 tumors; and 100% for tumors with negative surgical margin and 50% for tumors with positive surgical margin. Stage, grade, and surgical margins were independent prognostic factors. Adjuvant radiotherapy was performed for high-grade and high-stage tumors.

Conclusions: Surgery followed by radiotherapy has remained a mainstay for management of n-ITAC, and the endoscopic transnasal approach, when correctly planned and indicated, is the surgery of choice. Adjuvant radiotherapy is recommended in cases of high-stage (T3 and T4) and high-grade tumors. n-ITAC is associated with a favorable outcome. High grade, pT4 stage, and positive surgical margins are independent negative prognostic factors.

Keywords: Endoscopic surgery; Non–intestinal-type adenocarcinoma; Sinonasal adenocarcinoma; Sinonasal malignancies; Skull base.

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy*
  • Adult
  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Natural Orifice Endoscopic Surgery
  • Paranasal Sinus Neoplasms / diagnosis
  • Paranasal Sinus Neoplasms / mortality
  • Paranasal Sinus Neoplasms / pathology
  • Paranasal Sinus Neoplasms / therapy*
  • Prognosis
  • Retrospective Studies