A multi-institutional retrospective study of 340 cases of sinonasal malignant tumor

Takuya Tsuji; Ryo Asato; Shinpei Kada; Morimasa Kitamura; Hisanobu Tamaki; Masanobu Mizuta; Shinzo Tanaka; Yoshiki Watanabe; Ryusuke Hori; Tsuyoshi Kojima; Shogo Shinohara; Shinji Takebayashi; Toshiki Maetani; Hiroyuki Harada; Yoshiharu Kitani; Yohei Kumabe; Takashi Tsujimura; Keigo Honda; Kazuyuki Ichimaru; Koji Ushiro; Koichi Omori

doi:10.1016/j.anl.2023.05.002

A multi-institutional retrospective study of 340 cases of sinonasal malignant tumor

Auris Nasus Larynx. 2024 Feb;51(1):86-98. doi: 10.1016/j.anl.2023.05.002. Epub 2023 May 27.

Authors

Takuya Tsuji¹, Ryo Asato², Shinpei Kada³, Morimasa Kitamura⁴, Hisanobu Tamaki⁵, Masanobu Mizuta⁶, Shinzo Tanaka⁷, Yoshiki Watanabe⁸, Ryusuke Hori⁹, Tsuyoshi Kojima¹⁰, Shogo Shinohara¹¹, Shinji Takebayashi¹², Toshiki Maetani¹³, Hiroyuki Harada¹³, Yoshiharu Kitani¹⁴, Yohei Kumabe¹⁵, Takashi Tsujimura¹⁶, Keigo Honda¹⁷, Kazuyuki Ichimaru¹⁸, Koji Ushiro¹⁹, Koichi Omori²⁰

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan. Electronic address: tsuji_takuya@ent.kuhp.kyoto-u.ac.jp.
² Department of Otolaryngology, Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan.
³ Department of Otolaryngology, Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan; Department of Otolaryngology, Head and Neck Surgery, Japanese Red Cross Otsu Hospital, 1-1-35, Nagara, Otsu-shi, Shiga, 520-8511, Japan.
⁴ Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; Department of Head and Neck-Thyroid Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa 920-0293, Japan.
⁵ Department of Otolaryngology, Head and Neck Surgery, Japanese Red Cross Osaka Hospital, 5-30, Fudegasakicho, Tennouji-ku, Osaka-shi, Osaka 543-8555, Japan.
⁶ Department of Otolaryngology, Head and Neck Surgery, Japanese Red Cross Osaka Hospital, 5-30, Fudegasakicho, Tennouji-ku, Osaka-shi, Osaka 543-8555, Japan; Katsuragawa Mizuta ENT Clinic, 37 Shimotsubayashiminamidaihan-nya-cho, Nishikyo-ku, Kyoto-shi, Kyoto, 615-8036, Japan.
⁷ Department of Otolaryngology, Head and Neck Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan; Department of Otolaryngology, Head and Neck Surgery, Uji-Tokushukai Medical Center, 145 Ishibashi, Makishima-cho, Uji-shi, Kyoto, 611-0041, Japan.
⁸ Department of Otolaryngology, Head and Neck Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan.
⁹ Department of Otolaryngology, Tenri Hospital, 200 Misima-cho, Tenri-shi, Nara, 632-8552, Japan; Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Occupational and Environmental Health.
¹⁰ Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; Department of Otolaryngology, Tenri Hospital, 200 Misima-cho, Tenri-shi, Nara, 632-8552, Japan.
¹¹ Department of Otolaryngology, Head and Neck Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo, 650-0047, Japan.
¹² Department of Otolaryngology, Head and Neck Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo, 650-0047, Japan; Department of Otorhinolaryngology, Shiga General Hospital, 5-4-30, Moriyama, Moriyama-shi, Shiga, 524-8524, Japan.
¹³ Department of Otolaryngology, Head and Neck Surgery, Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan.
¹⁴ Department of Otolaryngology, Head and Neck Surgery, Shizuoka General Hospital, 4-27-1 Kita Ando Aoi-ku, Shizuoka City, 420-8527, Japan.
¹⁵ Department of Otolaryngology, Head and Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Nanba-cho, Amagasaki-shi, Hyogo, 660-8550, Japan.
¹⁶ Department of Otolaryngology, Head and Neck Surgery, Japanese Red Cross Otsu Hospital, 1-1-35, Nagara, Otsu-shi, Shiga, 520-8511, Japan; Department of Otolaryngology, Head and Neck Surgery, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama City, Wakayama, 640-8558, Japan.
¹⁷ Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; Department of Otolaryngology, Head and Neck Surgery, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama City, Wakayama, 640-8558, Japan.
¹⁸ Department of Otolaryngology, Head and Neck Surgery, Kokura Memorial Hospital, 3-2-1, Asano, Kokurakita-ku, Kitakyushu-shi, Fukuoka, 802-8555, Japan.
¹⁹ Department of Otolaryngology, Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan; Department of Otorhinolaryngology, Shiga General Hospital, 5-4-30, Moriyama, Moriyama-shi, Shiga, 524-8524, Japan.
²⁰ Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.

PMID: 37248104
DOI: 10.1016/j.anl.2023.05.002

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.

Conclusion: For patients with MSSCC without lymph node metastasis, aggressive surgery on the primary tumor contributes to improved prognosis.

Keywords: Clinical lymph node metastasis; Maxillary sinus squamous cell carcinoma; Renal dysfunction; Sinonasal malignant tumor.

Publication types

Multicenter Study

MeSH terms

Aged
Carcinoma, Squamous Cell* / epidemiology
Carcinoma, Squamous Cell* / therapy
Esthesioneuroblastoma, Olfactory* / pathology
Esthesioneuroblastoma, Olfactory* / therapy
Humans
Kidney Diseases*
Lymphatic Metastasis
Melanoma* / pathology
Nasal Cavity / pathology
Nose Neoplasms* / epidemiology
Nose Neoplasms* / pathology
Nose Neoplasms* / therapy
Paranasal Sinus Neoplasms* / pathology
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck / therapy