Head and Neck Institute, Cleveland Clinic, Cleveland, OH, USA.
Am J Otolaryngol. 2011 Nov-Dec;32(6):464-9. doi: 10.1016/j.amjoto.2010.09.006. Epub 2010 Oct 30.
The purpose of the study was to review a single-institution experience with endoscopic resection of sinonasal undifferentiated carcinoma (SNUC).
Thirteen patients underwent treatment of SNUC between January 2002 and July 2009. Retrospective data were collected including demographics, tumor characteristics, surgical strategy, adjuvant therapies, local and regional recurrence, distant metastasis, overall survival, and disease-free survival.
The mean age was 51.8 years. The most common tumor stage at presentation was T4 (92%). Seven patients (53%) were treated with minimally invasive endoscopic resection (MIER) with negative intraoperative margins. Endoscopic anterior skull base resection was performed in 5 patients, and endoscopic-assisted bifrontal craniotomy was performed in 1 patient to clear the superior tumor margin. Six patients received pre- or postoperative chemoradiation. One patient underwent palliative chemoradiation, and one patient underwent open craniofacial resection. In the MIER group, simultaneous local and regional recurrence was observed in 1 patient (14%) after 30 months. Distant metastases were observed in 2 other patients (28%) without local or regional recurrence. All 3 patients with recurrences died of their disease. The remaining 4 patients were clinically, endoscopically, and radiographically free of disease, resulting in overall and disease-free survival rates of 57% with mean follow-up of 32.3 months.
These preliminary data suggest a potential role for MIER in the comprehensive management algorithm of SNUC in appropriately selected patients. Patient outcomes including local and regional recurrence, distant metastases, and overall and disease-free survival were comparable to a treatment strategy using traditional craniofacial resection.
2b.
本研究旨在回顾单一机构内镜治疗鼻腔鼻窦未分化癌（SNUC）的经验。
2002 年 1 月至 2009 年 7 月，13 例患者接受了 SNUC 治疗。收集了包括人口统计学、肿瘤特征、手术策略、辅助治疗、局部和区域复发、远处转移、总生存和无病生存等回顾性数据。
平均年龄为 51.8 岁。就诊时最常见的肿瘤分期为 T4（92%）。7 例（53%）患者接受了微创内镜下切除术（MIER），术中切缘阴性。5 例患者行内镜前颅底切除术，1 例患者行内镜辅助额骨切除术以清除肿瘤上缘。6 例患者接受了术前或术后放化疗。1 例患者接受了姑息性放化疗，1 例患者接受了开放性面颅切除术。在 MIER 组中，1 例患者（14%）在 30 个月后出现局部和区域同时复发。另外 2 例（28%）患者无局部或区域复发但出现远处转移。所有 3 例复发患者均因疾病死亡。其余 4 例患者临床、内镜和影像学均无疾病，总生存率和无病生存率分别为 57%，平均随访 32.3 个月。
这些初步数据表明，MIER 可能在适当选择的患者中成为 SNUC 综合治疗方案的一部分。患者的结局包括局部和区域复发、远处转移、总生存和无病生存，与传统面颅切除术的治疗策略相当。
2b。
