内镜手术在鼻腔筛窦复合体特定恶性上皮性肿瘤治疗中的作用

Role of endoscopic surgery in the management of selected malignant epithelial neoplasms of the naso-ethmoidal complex.

作者信息

Nicolai Piero, Castelnuovo Paolo, Lombardi Davide, Battaglia Paolo, Bignami Maurizio, Pianta Luca, Tomenzoli Davide

机构信息

Department of Otorhinolaryngology, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy.

出版信息

Head Neck. 2007 Dec;29(12):1075-82. doi: 10.1002/hed.20636.

DOI:10.1002/hed.20636

PMID:17492654

Abstract

BACKGROUND

This study reviews the outcome of patients with adenocarcinoma (AC) and squamous cell carcinoma (SCC) of the naso-ethmoidal complex treated by endoscopic surgery.

METHODS

Sixteen patients underwent a purely endoscopic excision of AC (n = 12) or SCC (n = 4) at 2 university hospitals. All patients were prospectively followed by endoscopic and MRI evaluations.

RESULTS

The tumor originated from the ethmoid in 13 cases and the nasal fossa in 3. Lesions were staged as follows: 5 T1, 10 T2, and 1 T3. Adjuvant radiotherapy was delivered in 7 cases. Follow-up (range, 28-70 months; mean, 47.25) was available for all patients. One patient died for brain metastases 28 months after surgery. Another patient required salvage craniofacial resection and radiotherapy for recurrent AC. Five-year disease-specific and disease-free survival rates were 93.3% and 87.0%, respectively.

CONCLUSIONS

In selected T1-T2 lesions of the naso-ethmoidal complex, endoscopic surgery seems to offer a satisfactory alternative to external procedures.

摘要

背景

本研究回顾了经鼻内镜手术治疗的鼻筛窦复合体腺癌（AC）和鳞状细胞癌（SCC）患者的治疗结果。

方法

16例患者在2所大学医院接受了单纯鼻内镜下AC（n = 12）或SCC（n = 4）切除术。所有患者均接受了内镜和MRI的前瞻性评估。

结果

肿瘤起源于筛窦13例，鼻腔3例。病变分期如下：5例T1期，10例T2期，1例T3期。7例患者接受了辅助放疗。所有患者均获得随访（范围28 - 70个月；平均47.25个月）。1例患者术后28个月死于脑转移。另1例复发性AC患者需要挽救性颅面切除术和放疗。5年疾病特异性生存率和无病生存率分别为93.3%和87.0%。