Grosjean Rémy, Gallet Patrice, Baumann Cédric, Jankowski Roger
Head and Neck Surgery, CHU, de Nancy-Hôpital Central, Nancy, France; University of Lorraine, Nancy, France.
Head Neck. 2015 Mar;37(3):347-56. doi: 10.1002/hed.23601. Epub 2014 Jun 16.
The purpose of this study was to present a monocentric retrospective study designed to compare oncologic results and morbidity between transfacial surgery and endoscopic endonasal surgery for nasal adenocarcinomas.
Between 1998 and 2003, 31 patients were operated on via transfacial surgery, and between 2004 and 2009, 43 patients were operated on via endoscopic endonasal surgery. Overall and specific survival, local control, and morbidity (length of hospitalization, intensive care unit [ICU] monitoring, need for nasal packing, and complications) were compared.
There was no difference in prognostic factors between groups, but the median age was significantly higher for endoscopic endonasal surgery. Three-year overall survival, specific survival, and local control were not different between groups (respectively, 76.7%, 86%, and 81.4% for endoscopic endonasal surgery vs 61.3%, 67.7%, and 71% for transfacial surgery). Morbidity was significantly lower with endoscopic endonasal surgery for all criteria.
Endoscopic surgery may replace transfacial surgery in the treatment of woodworker's adenocarcinomas. Older patients can be operated on by decreasing morbidity and mortality with at least similar oncologic results.
本研究旨在进行一项单中心回顾性研究，以比较经面部手术和鼻内镜鼻内手术治疗鼻腺癌的肿瘤学结果和发病率。
1998年至2003年间，31例患者接受了经面部手术，2004年至2009年间，43例患者接受了鼻内镜鼻内手术。比较了总生存率和特定生存率、局部控制情况以及发病率（住院时间、重症监护病房[ICU]监测、鼻腔填塞需求和并发症）。
两组之间的预后因素没有差异，但鼻内镜鼻内手术患者的中位年龄显著更高。两组之间的三年总生存率、特定生存率和局部控制情况没有差异（鼻内镜鼻内手术分别为76.7%、86%和81.4%，经面部手术分别为61.3%、67.7%和71%）。就所有标准而言，鼻内镜鼻内手术的发病率显著更低。
在木工腺癌的治疗中，内镜手术可能会取代经面部手术。老年患者可以通过降低发病率和死亡率进行手术，且肿瘤学结果至少相似。
