Bussu Francesco, Tagliaferri Luca, Crescio Claudia, Rizzo Davide, Gallus Roberto, Parrilla Claudio, Fionda Bruno, Lancellotta Valentina, Mattiucci Gian Carlo, Galli Jacopo
Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy.
Otolaryngology, Department of Medicine, Surgery and Pharmacy, Università di Sassari, Italy.
Acta Otolaryngol. 2023 Mar;143(3):215-222. doi: 10.1080/00016489.2023.2179662. Epub 2023 Feb 28.
Nasal vestibule squamous cell carcinoma (NVSCC) is an ill-defined underestimated condition.
AIM/OBJECTIVE: To define the current standard of care.
We review recent acquisitions concerning clinical features and therapeutic approaches.
The current AJCC staging system, which attributes to nasal vestibule the same topographic code as nasal cavity proper and the same T-classification criteria as ethmoid, appears inadequate.As for treatment of primary lesions without bone invasion, current evidence suggests that brachytherapy is at least equivalent to surgery and superior to external beams in terms of oncological outcomes, and superior to both modalities in terms of cosmesis and function.
As for classification and staging, the nasal vestibule should be defined as a subsite of the nose and paranasal sinuses, distinct from the 'nasal cavity proper and ethmoid', with specific topographic code and T-classification criteria. This will improve the assessment of prognosis and prevalence, underestimated also because of misdiagnosis with skin cancers.Secondly, brachytherapy should become the new standard for the treatment of primary lesions without bone invasion. To optimize the advantages of brachytherapy, we propose novel anatomic criteria for the implantation.
Increasing evidence supports a paradigm shift in staging and treatment of NVSCC.
鼻前庭鳞状细胞癌（NVSCC）是一种定义不明确且被低估的疾病。
确定当前的治疗标准。
我们回顾了有关临床特征和治疗方法的最新研究成果。
目前的美国癌症联合委员会（AJCC）分期系统，将鼻前庭与鼻腔本部赋予相同的部位编码，并与筛窦采用相同的T分类标准，似乎并不充分。对于无骨侵犯的原发性病变的治疗，目前的证据表明，近距离放射治疗在肿瘤学结局方面至少与手术相当，且优于外照射，在美容和功能方面优于这两种治疗方式。
在分类和分期方面，鼻前庭应被定义为鼻和鼻窦的一个亚部位，与“鼻腔本部和筛窦”不同，具有特定的部位编码和T分类标准。这将改善对预后和患病率的评估，由于与皮肤癌的误诊，其也被低估。其次，近距离放射治疗应成为无骨侵犯的原发性病变治疗的新标准。为了优化近距离放射治疗的优势，我们提出了新的植入解剖学标准。
越来越多的证据支持鼻前庭鳞状细胞癌在分期和治疗方面的范式转变。
