Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Laryngoscope. 2023 Oct;133(10):2603-2612. doi: 10.1002/lary.30567. Epub 2023 Feb 6.
This study aims to investigate the utility of adjuvant radiation in patients who undergo surgical resection for the management of node-negative sinonasal adenocarcinoma (SNAC).
Retrospective database review.
The 2004-2016 National Cancer Data Base (NCDB) was used to extract patients with surgically resected node-negative SNAC. Kaplan-Meier survival analysis and Cox-Proportional Hazards Modelling were used to analyze the impact of adjuvant radiation on overall survival (OS) following surgery.
349 patients with SNAC underwent surgical resection. Of these patients, 154 (44.1%) received adjuvant radiotherapy (RT). Although there was no significant difference in race, age, or sex of those receiving RT, those receiving RT have more advanced diseases and are more likely to have positive margins. Kaplan Meier analysis showed no significant difference in 5-year OS in patient who received adjuvant RT in comparison to those who underwent surgical resection alone (65.7% vs. 72.6%, respectively; p = 0.378). In addition, when looking at only patients with positive margins, 5-year OS still did not have a significant difference (73.8% vs. 61.6%, respectively; p = 0.101). Only patients with clinical AJCC T4 showed a statistically significant survival benefit with adjuvant RT (56.9% vs. 29.9%, respectively; p = 0.009).
Adjuvant RT does not appear to provide a significant survival benefit in patients with resected SNAC, with the exception of those with clinically AJCC T4 disease.
4 Laryngoscope, 133:2603-2612, 2023.
本研究旨在探讨辅助放疗在接受手术切除治疗淋巴结阴性鼻窦腺癌（SNAC）患者中的应用价值。
回顾性数据库研究。
本研究使用 2004 年至 2016 年国家癌症数据库（NCDB）提取接受手术切除治疗且淋巴结阴性的 SNAC 患者。采用 Kaplan-Meier 生存分析和 Cox 比例风险模型分析辅助放疗对手术切除后总生存期（OS）的影响。
349 例 SNAC 患者接受了手术切除。其中 154 例（44.1%）患者接受了辅助放疗（RT）。尽管接受 RT 的患者在种族、年龄和性别方面无显著差异，但他们的疾病更为晚期，且更有可能存在切缘阳性。Kaplan-Meier 分析显示，与单独接受手术切除的患者相比，接受辅助 RT 的患者 5 年 OS 无显著差异（分别为 65.7%和 72.6%，p=0.378）。此外，仅观察切缘阳性的患者时，5 年 OS 仍无显著差异（分别为 73.8%和 61.6%，p=0.101）。仅临床 AJCC T4 患者接受辅助 RT 后具有显著的生存获益（56.9%比 29.9%，p=0.009）。
除了临床 AJCC T4 疾病患者外，辅助 RT 似乎并不能为接受切除治疗的 SNAC 患者提供显著的生存获益。
4 级《喉镜》，133：2603-2612，2023。
