Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, centre hospitalier universitaire d'Angers, 20, rue de Savoie, 49100 Angers cedex 01, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2011 Nov;128(5):211-7. doi: 10.1016/j.anorl.2011.02.012. Epub 2011 May 26.
Retrospective analysis of the oncological results and morbidity of ethmoid sinus adenocarcinoma surgery, and identification of survival factors.
Forty-two patients were treated from 1990 to 2009. The study covered clinical presentation, medical imaging, histologic data, TNM grade, treatment, morbidity and overall recurrence-free survival.
Forty-one men and one woman, with mean age at diagnosis of 61.5 years, were included. 85.7% had been exposed to wood dust. Twenty patients (47.6%) were graded T4 at diagnosis. Thirty-three (78.5%) were treated by surgery followed by radiation therapy; nearly half of these showed recurrence. Overall specific 5-year survival was 44.2% at 5 years and recurrence-free 5-year survival 46.4%. The factors of poor prognosis found were cerebromeningeal or orbital invasion and local recurrence.
This series confirms the epidemiological literature on ethmoid adenocarcinoma and the influence of poor prognosis factors. Survival depended directly on local tumor control and seemed to be enhanced on an isolated transfacial approach.
回顾分析筛窦腺癌的肿瘤学结果和发病率，并确定生存因素。
1990 年至 2009 年间共治疗了 42 例患者。研究涵盖了临床表现、医学影像学、组织学数据、TNM 分级、治疗、发病率和整体无复发生存率。
共纳入 41 名男性和 1 名女性患者，诊断时的平均年龄为 61.5 岁。85.7%的患者接触过木屑。20 例（47.6%）患者在诊断时被评为 T4 期。33 例（78.5%）患者接受了手术联合放疗；其中近一半患者出现复发。5 年总体特异性生存率为 44.2%，5 年无复发生存率为 46.4%。预后不良的因素为脑脊髓或眼眶侵犯和局部复发。
本系列研究证实了筛窦腺癌的流行病学文献和预后不良因素的影响。生存直接取决于局部肿瘤控制，单独采用经面中部入路似乎可以提高生存。
