Department of Otolaryngology Head and Neck Surgery, 117902Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.
Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, PR China.
Am J Rhinol Allergy. 2021 Jan;35(1):114-121. doi: 10.1177/1945892420939422. Epub 2020 Jul 12.
The prognostic factors and survival difference between inverted papilloma (IP)-associated sinonasal squamous cell carcinoma (SCC) and de novo SCC are unclear.
This study aimed to compare the clinical features and oncologic outcomes in patients with IP-associated SCC and de novo SCC; and additionally, to analyze the prognostic factors of the two types of SCCs.
Data from 173 SCC patients treated for IP-associated SCC (n = 89) and de novo SCC (n = 84), were reviewed retrospectively for demographic features, tumor characteristics, treatment modality, and clinical outcomes. 5-year overall survival (OS) and disease free survival (DFS) was analyzed using the Kaplan-Meier method, and Cox proportional hazards model was used to analyze factors influencing prognosis.
A higher proportion of IP-associated SCC occurred in frontal and sphenoid sinus compared to de novo SCC. The two groups demonstrated similar 5-year OS and DFS (5-year OS: 63.3% and 55.4%, DFS: 45.4% and 50.1%, respectively). The metachronous tumor had a relatively better prognosis outcome than synchronous tumor and de novo SCC (5-year OS: 73.1%, 54.5% and 55.4%, respectively). Both groups showed similar loco-regional recurrence rates ( > 0.05); however, de novo SCC tumors demonstrated an increased incidence of distant metastasis. Multivariate analysis indicated that age >70 years, advanced tumor stage and surgical margin were independent predictive factors for the risk of mortality (HR 2.047, 1.581 and 1.931, respectively).
IP-associated SCCs have an aggressive loco-regional tendency, whereas de novo SCCs have a higher aggressive distant metastatic propensity. Age, tumor stage and surgical positive margin are key factors for poor prognosis and should be routinely taken into consideration during treatment planning and subsequent surveillance.
鼻内翻性乳头状瘤（IP）相关的鼻窦鳞状细胞癌（SCC）与原发性 SCC 的预后因素和生存差异尚不清楚。
本研究旨在比较 IP 相关 SCC 和原发性 SCC 患者的临床特征和肿瘤学结果；并分析两种 SCC 的预后因素。
回顾性分析了 173 例接受 IP 相关 SCC（n=89）和原发性 SCC（n=84）治疗的 SCC 患者的数据，分析了人口统计学特征、肿瘤特征、治疗方式和临床结果。采用 Kaplan-Meier 法分析 5 年总生存率（OS）和无病生存率（DFS），采用 Cox 比例风险模型分析影响预后的因素。
与原发性 SCC 相比，IP 相关 SCC 更多发生于额窦和蝶窦。两组患者的 5 年 OS 和 DFS 相似（5 年 OS：63.3%和 55.4%，DFS：45.4%和 50.1%）。与原发性 SCC 相比，同期肿瘤和异时性肿瘤的预后较好（5 年 OS：73.1%、54.5%和 55.4%）。两组患者的局部区域复发率相似（>0.05）；然而，原发性 SCC 肿瘤远处转移发生率较高。多因素分析表明，年龄>70 岁、肿瘤分期较晚和手术切缘阳性是死亡风险的独立预测因素（HR 2.047、1.581 和 1.931）。
IP 相关 SCC 具有侵袭性的局部区域倾向，而原发性 SCC 具有较高的侵袭性远处转移倾向。年龄、肿瘤分期和手术阳性切缘是不良预后的关键因素，在治疗计划和随后的监测中应常规考虑。
