Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy; Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy.
Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, University of Genoa, Genoa, Italy.
Oral Oncol. 2020 Jul;106:104672. doi: 10.1016/j.oraloncology.2020.104672. Epub 2020 Apr 13.
Maxillary sinus cancer is a rare disease with heterogeneous biologic behavior. The pattern of neurovascular invasion is known to be an important prognosticator in head and neck cancers, but has not been studied in maxillary malignancies.
Patients undergoing surgery-based treatment with curative intent for a malignancy of the maxillary sinus at the Unit of Otorhinolaryngology - Head and Neck Surgery of the University of Brescia between November 2000 and October 2018 were included. A description of the characteristics of the patients, tumors, and treatments has been performed along with uni- and multi-variate analysis of prognostic factors. Tumors were classified based on the presence of perineural (P/P) and lymphovascular invasion (V/V) in 4 categories: PV, PV, PV, and PV.
One hundred-thirty-eight patients were included. Mean age at surgery was 61.0 years. Most patients (60.1%) were affected by non-salivary carcinomas, and most tumors (73.9%) were high-grade cancers. One hundred-seven (77.5%) tumors were classified as pT4. The large majority of patients received bi- or tri-modality treatment. Sixty-three (45.7%) cases were classified as PV, 32 (23.2%) as PV, 7 (5.1%) as PV, and 36 (26.1%) as PV. T category, nodal status, and neurovascular invasion were significantly associated with prognosis. Perineural and lymphovascular invasion were associated with the topographical growth of the tumor.
Maxillary cancer is often diagnosed at an advanced stage and in most cases requires a multimodal approach. Perineural and lymphovascular invasion are frequent and have a different impact on prognosis and topographical extension of the tumor.
上颌窦癌是一种罕见的疾病，具有异质的生物学行为。神经血管侵犯模式已知是头颈部癌症的重要预后因素，但尚未在上颌恶性肿瘤中进行研究。
纳入了 2000 年 11 月至 2018 年 10 月期间在布雷西亚大学耳鼻喉科-头颈外科手术治疗有治愈意图的上颌窦恶性肿瘤的患者。对患者、肿瘤和治疗进行了描述，并对预后因素进行了单变量和多变量分析。根据肿瘤是否存在神经周围（P/P）和血管淋巴管侵犯（V/V）将肿瘤分为 4 类：PV、PV、PV 和 PV。
共纳入 138 例患者。手术时的平均年龄为 61.0 岁。大多数患者（60.1%）患有非涎腺癌，大多数肿瘤（73.9%）为高级别癌症。107 例（77.5%）肿瘤被归类为 pT4。绝大多数患者接受了双或三模式治疗。63 例（45.7%）病例被归类为 PV，32 例（23.2%）为 PV，7 例（5.1%）为 PV，36 例（26.1%）为 PV。T 分期、淋巴结状态和神经血管侵犯与预后显著相关。神经周围和血管淋巴管侵犯与肿瘤的局部生长有关。
上颌窦癌通常在晚期诊断，大多数情况下需要采用多模式方法。神经周围和血管淋巴管侵犯很常见，对预后和肿瘤的局部扩展有不同的影响。
