Primary malignancies of the nasal fossa and paranasal sinuses: comparison between UICC classification and a new staging system.

There is not a general accepted classification for tumor of nasal cavity and paranasal sinuses, and furthermore, there is a lack in the most commonly used T staging, the Union Internationale Contre Cancer (UICC) and the American Joint Committee on Cancer systems, which offer a classification strictly for tumors of the maxillary antrum. A new T staging (NTS) has been proposed: It is applicable to neoplasms arising from the mucosa of nasal fossa and all paranasal sinuses. To evaluate the advantages of NTS, a retrospective analysis of 54 cases of paranasal sinus cancers in patients admitted between 1983 and 1993 was undertaken. Tumors were staged according to UICC and to NTS systems, and then a statistical comparison was performed. Univariate analysis stratified according with T stage, tumors origin, and treatment modalities demonstrated different survival rates in both systems. Multivariate analysis showed a higher risk of death into the T4 category coded according with NTS with respect to UICC system. We concluded that NTS offers some advantages: (1) It presents a general view of the maxillofacial cavities; (2) it prognosticates successfully for T stage (1-4); (3) it gives significant improvement in detecting the risk of death for T4 when compared with the UICC system.