Department of Ear, Nose and Throat Surgery, Sheffield Teaching Hospitals Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Broomhall, Sheffield, S10 2JF, UK.
Department of Surgery, University Cancer Institute Toulouse-Oncopole, Toulouse, France.
Eur Arch Otorhinolaryngol. 2022 Apr;279(4):2069-2075. doi: 10.1007/s00405-021-06972-6. Epub 2021 Jul 5.
This study aims to analyse the oncological outcomes of total rhinectomy (TR) for squamous cell carcinomas (SCCs) involving the nasal vestibule, and to identify prognostic factors for disease recurrence.
A retrospective single-centre study was conducted between September 2003 and February 2021 including all patients who underwent a TR for a SCC involving the nasal vestibule.
23 patients were included in the study. Tumours originated from the anterior septum (n = 12), vestibule (n = 8) or skin (n = 3). Six TRs (26.1%) were salvage procedures, after primary radiotherapy or partial rhinectomy. Seven patients had a concurrent neck dissection and 17 patients (73.9%) received adjuvant treatment (14 patients had radiotherapy and 3 had chemoradiotherapy). After a median follow-up of 32 months, six patients (26.1%) presented with tumour recurrence. Three patients (13%) had nodal-only recurrence. The estimated 5-year overall survival, disease-free survival and disease-specific survival were 67.5%, 66.3% and 80.7%, respectively. Positive excision margins were a predictive factor for tumour recurrence (p = 0.0401).
For SCCs involving the nasal vestibule that are not amenable to limited surgical resection, TR along with adjuvant radiotherapy provide good oncological outcomes and should be considered the main treatment option.
本研究旨在分析全鼻切除术（TR）治疗累及鼻前庭的鳞状细胞癌（SCC）的肿瘤学结果，并确定疾病复发的预后因素。
本研究为 2003 年 9 月至 2021 年 2 月进行的单中心回顾性研究，纳入所有接受累及鼻前庭 SCC 的 TR 治疗的患者。
本研究纳入 23 例患者。肿瘤起源于前鼻中隔（n=12）、前庭（n=8）或皮肤（n=3）。6 例 TR（26.1%）为原发性放疗或部分鼻切除术的挽救性手术。7 例患者同期行颈清扫术，17 例（73.9%）患者接受辅助治疗（14 例放疗，3 例放化疗）。中位随访 32 个月后，6 例患者（26.1%）出现肿瘤复发。3 例患者（13%）仅出现淋巴结复发。估计 5 年总生存率、无病生存率和疾病特异性生存率分别为 67.5%、66.3%和 80.7%。切缘阳性是肿瘤复发的预测因素（p=0.0401）。
对于不能行局限性手术切除的累及鼻前庭的 SCC，TR 联合辅助放疗可获得良好的肿瘤学结果，应作为主要治疗选择。
