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[鼻腔及鼻窦鳞状细胞癌患者的管理与预后]

[Management and prognosis of patients with squamous cell carcinomas of the nasal cavity and the paranasal sinuses].

作者信息

Pickhard A, Durst F, Staudenmaier R, Reiter R

机构信息

Hals-Nasen-Ohrenklinik, Technische Universität München, Ismaninger Straße 22, Munich.

出版信息

Laryngorhinootologie. 2012 Oct;91(10):627-32. doi: 10.1055/s-0032-1321867. Epub 2012 Aug 28.

Abstract

Squamous cell carcinomas (SCC) of the nasal cavity and the paranasal sinuses are a very rare and poorly understood tumor entity. To date, no consistent management strategy exists. The purpose of our study was to demonstrate our therapeutic strategy and to correlate clinicopathological features with clinical follow-up data.45 patients with primarily resected SCC of the nasal cavity (n=35) and the paranasal sinuses (n=10) between 1994 and 2010 were reviewed retrospectively (mean follow-up period 2.6 years; range 0.3 to 14.9 years).Tumors of the nasal cavity were diagnosed at an early stage (97% T1 and T2) whereas tumors of the parasinuses were found at an advanced stage (90% T3 and T4). Lymph node metastases were only found 2 patients. 13 patients (29%) had a local tumor progress, 2 patients showed lymph node metastases and 4 patients had distant metastases in follow up. The prognosis of tumors of the nasal cavitiy or the paranasal sinuses was bad (31% 5-year overall survival) especially by patients with a relapse.Reconstructive surgery was performed after 12 months, when early local relapse could be excluded. There was no positive correlation between clinicopathological features and survival data.The prognosis of tumors of the nasal cavity and paranasal sinuses depends mainly on the control of local tumor growth. Modern strategies of surgical treatment in combination with radiotherapy need to be implemented in an effort to achieve continuous tumor-free survival.

摘要

鼻腔和鼻窦鳞状细胞癌(SCC)是一种非常罕见且了解甚少的肿瘤实体。迄今为止,尚无一致的管理策略。我们研究的目的是展示我们的治疗策略,并将临床病理特征与临床随访数据相关联。回顾性分析了1994年至2010年间45例主要接受鼻腔(n = 35)和鼻窦(n = 10)鳞状细胞癌切除术的患者(平均随访期2.6年;范围0.3至14.9年)。鼻腔肿瘤多在早期诊断(97%为T1和T2期),而鼻窦肿瘤多在晚期发现(90%为T3和T4期)。仅2例患者出现淋巴结转移。随访中,13例患者(29%)出现局部肿瘤进展,2例出现淋巴结转移,4例出现远处转移。鼻腔或鼻窦肿瘤的预后较差(5年总生存率为31%),尤其是复发患者。在排除早期局部复发后,12个月后进行重建手术。临床病理特征与生存数据之间无正相关。鼻腔和鼻窦肿瘤的预后主要取决于局部肿瘤生长的控制。需要实施现代手术治疗与放疗相结合的策略,以实现持续无瘤生存。

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