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鼻窦恶性肿瘤:预后因素与手术结果

Sinonasal tract malignancies: prognostic factors and surgery outcomes.

作者信息

Bugra Cengiz Abdurrahman, Uyar Melek, Comert Ela, Dursun Engin, Eryilmaz Adil

机构信息

Department of Otorhinolaryngology, Oncology Hospital, Ankara, Turkey.

Department of Otorhinolaryngology, Recep Tayyip Erdoğan University, Rize, Turkey.

出版信息

Iran Red Crescent Med J. 2013 Dec;15(12):e14118. doi: 10.5812/ircmj.14118. Epub 2013 Dec 5.

Abstract

BACKGROUND

Cancers of the sinonasal region are rare and its survival rate remains poor because most of the patients are asymptomatic and diagnosed in advanced stages with surrounding important structures.

OBJECTIVES

This study attempted to analyze the clinical and histological features in addition to survival and prognostic factors of surgical treatment of sinonasal cancers.

PATIENTS AND METHODS

A retrospective cohort study, involving 36 patients with sinonasal cancer who were treated with surgery in our hospital between 2000 and 2010, was performed. Patients were selected based on the convenience sampling. Patients treated with radiotherapy and/or chemotherapy were excluded from the analysis. Clinical symptoms and histologic findings of patients as well as malignant tumor staging and its prognosis were collected from archives.

RESULTS

We found that overall 3 and 5-year survival rates of subjects were 52.8%, and 41.6%, respectively. There was a negative correlation between the clinical stage and survival. There was a significant difference between infrastructural and suprastructural localization in 5-year survival rate (P = 0.018). In the present study, there was a strong relationship between the local control and overall survival (P < 0.01). Overall 5-year survival rate was similar in patients both in the exenterated orbit and preserved orbit (P > 0.05).

CONCLUSIONS

The present study has demonstrated that clinical stage, suprastructural tumor, and the presence of tumor- positive resection margins are the most significant prognostic factors affecting local tumor control and survival. As a result of this study, these tumors should be treated in early stages by surgical margin of resection followed by adjuvant radiotherapy.

摘要

背景

鼻窦区域的癌症较为罕见,由于大多数患者无症状,且在疾病晚期才被诊断出来,周围还有重要结构,因此其生存率仍然很低。

目的

本研究试图分析鼻窦癌手术治疗的临床和组织学特征,以及生存率和预后因素。

患者与方法

进行了一项回顾性队列研究,纳入了2000年至2010年间在我院接受手术治疗的36例鼻窦癌患者。患者基于便利抽样进行选择。接受放疗和/或化疗的患者被排除在分析之外。从档案中收集患者的临床症状、组织学发现以及恶性肿瘤分期及其预后情况。

结果

我们发现,受试者的总体3年和5年生存率分别为52.8%和41.6%。临床分期与生存率之间呈负相关。5年生存率在结构内和结构上定位之间存在显著差异(P = 0.018)。在本研究中,局部控制与总体生存之间存在密切关系(P < 0.01)。眼眶切除和眼眶保留的患者总体5年生存率相似(P > 0.05)。

结论

本研究表明,临床分期、结构上的肿瘤以及肿瘤阳性切缘的存在是影响局部肿瘤控制和生存的最重要预后因素。基于本研究结果,这些肿瘤应在早期通过手术切除边缘进行治疗,随后进行辅助放疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2cc/3955510/4bcba807164e/ircmj-15-14118-i001.jpg

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本文引用的文献

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The controversy in the management of the N0 neck for squamous cell carcinoma of the maxillary sinus.上颌窦鳞癌 N0 颈部处理的争议。
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Treatment outcome of maxillary sinus squamous cell carcinoma.上颌窦鳞状细胞癌的治疗结果
Cancer. 2001 Sep 15;92(6):1495-503. doi: 10.1002/1097-0142(20010915)92:6<1495::aid-cncr1474>3.0.co;2-p.

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