Yee Leong Wai, Jumastapha H, Tang Chian Ling, Tang I P
Sarawak General Hospital, Kuching, Malaysia.
University Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia.
Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5833-5838. doi: 10.1007/s12070-024-05113-9. Epub 2024 Oct 8.
Sinonasal carcinoma, a rare and challenging malignancy, originating in the nasal cavity and paranasal sinuses, poses diagnostic and management complexities. This 8-year retrospective analysis at Sarawak General Hospital aims to elucidate demographic trends, histopathological entities, and management outcomes, shedding light on this multifaceted malignancy. Emphasizing the significance of accurate histopathological classification, the study explores the impact on prognostication and treatment strategies. Spanning 2013 to 2021, the study involved 54 patients with sinonasal malignancies. Demographic, clinical, and histopathological details were examined, adhered to the AJCC staging criteria. Analysis involved demographic distributions, tumour characteristics, treatment modalities, and instances of treatment failure. Statistical analysis was done using SPSS version 29.02. The cohort, predominantly male (57.4%) and of Iban ethnicity (44.4%), with a mean age of 52.8 years, exhibited diverse histopathologies, with squamous cell carcinoma as the most common (38.9%). Epistaxis and nasal blockage were common clinical presentations. Advanced stages (III and IV) were prevalent, with the nasal cavity as the primary site. Surgical interventions, mainly endoscopic endonasal excision, were complemented by adjuvant therapies. Complications occurred in 24% of cases. The study highlights a male predilection, occupational risk factors, and a significant association between tobacco smoking and sinonasal cancers. Surgical interventions predominantly utilized the endoscopic approach. Despite a mean survival of 46.6 months, treatment failure occurred in 29.6% of cases, with recurrence and metastasis. Histopathological analysis revealed comparable 5-year disease survival rates between squamous and non-squamous histologies. Treatment failure was significantly associated with the mode of surgery, with open surgery showing a lower incidence. However, nodal status, histopathology types, T staging, and overall staging did display positive associations with treatment failure. This 8-year review provides comprehensive insights into sinonasal carcinoma, addressing demographic, clinical, and histopathological dimensions. The study underlines the complexity of managing this challenging malignancy, emphasizing the need for a holistic approach to patient care. The findings contribute to the understanding of sinonasal carcinoma, guiding clinical decision-making and fostering further research.
鼻窦癌是一种罕见且具有挑战性的恶性肿瘤，起源于鼻腔和鼻窦，在诊断和治疗方面存在复杂性。这项在砂拉越综合医院进行的为期8年的回顾性分析旨在阐明人口统计学趋势、组织病理学类型及治疗结果，为这种多方面的恶性肿瘤提供线索。该研究强调准确的组织病理学分类的重要性，探讨其对预后和治疗策略的影响。研究时间跨度为2013年至2021年，涉及54例鼻窦恶性肿瘤患者。研究人员检查了人口统计学、临床和组织病理学细节，并遵循美国癌症联合委员会（AJCC）分期标准。分析内容包括人口统计学分布、肿瘤特征、治疗方式及治疗失败情况。使用SPSS 29.02版本进行统计分析。该队列主要为男性（57.4%），伊班族裔占44.4%，平均年龄52.8岁，呈现出多样的组织病理学类型，其中鳞状细胞癌最为常见（38.9%）。鼻出血和鼻塞是常见的临床表现。晚期（III期和IV期）较为普遍，鼻腔是主要发病部位。手术干预主要是鼻内镜下鼻内切除，并辅以辅助治疗。24%的病例出现并发症。该研究突出了男性易感性、职业风险因素，以及吸烟与鼻窦癌之间的显著关联。手术干预主要采用内镜方法。尽管平均生存期为46.6个月，但29.6%的病例出现治疗失败，伴有复发和转移。组织病理学分析显示，鳞状和非鳞状组织学类型的5年疾病生存率相近。治疗失败与手术方式显著相关，开放手术的发生率较低。然而，淋巴结状态、组织病理学类型、T分期和总体分期与治疗失败确实存在正相关。这项为期8年的综述全面洞察了鼻窦癌，涉及人口统计学、临床和组织病理学等方面。该研究强调了管理这种具有挑战性的恶性肿瘤的复杂性，强调需要采取整体的患者护理方法。这些发现有助于对鼻窦癌的理解，指导临床决策并促进进一步研究。
