Treatment Outcomes of Sinonasal Malignancies Involving the Orbit

Abstract

Objective Orbital invasion is associated with a poor prognosis in cases of sinonasal malignancy. This study aimed to analyze the oncological outcomes of sinonasal malignancies involving the orbit.

Patients and Methods We reviewed the medical records of 116 patients with a sinonasal malignancy who had orbital invasion at initial diagnosis and followed up at least 6 months between June 1991 and October 2017 at a single institute. The overall survival (OS), disease-specific survival (DSS), and progression-free survival (PFS) rates according to the clinicopathological factors, extent to orbit, and treatment modality were compared.

Results Patients were mainly treated with surgery and postoperative radiation (n = 39, 33.6%) and concurrent chemoradiation (n = 72, 62.1%). Only five patients (5.1%) underwent orbital exenteration. The OS, DSS, and PFS rates significantly decreased in patients older than 60 years of age and in patients with a higher Charlson Comorbidity Index Score (each p < 0.001). The OS and DSS rates were higher in patients at clinical T3 and N0 stage than in patients at clinical T4 and N1–2 stage (each p < 0.05). There were no significant differences in survival and local control rates according to the extent of orbital invasion, treatment modalities, and orbital preservation. However, neoadjuvant chemotherapy and adjuvant radiation or concurrent chemoradiation increased survival rates in the patients treated with surgery.

Conclusion Orbit preservation and relatively successful oncological outcome could be obtained with surgery and adjuvant radiation or concurrent chemoradiation.

Keywords

sinonasal malignancy - orbit - surgery - radiotherapy - chemoradiotherapy - survival

Publikationsverlauf

Eingereicht: 04. Januar 2021

Angenommen: 04. April 2021

Artikel online veröffentlicht:
29. Mai 2021

• References

• 1 Turner JH, Reh DD. Incidence and survival in patients with sinonasal cancer: a historical analysis of population-based data. Head Neck 2012; 34 (06) 877-885
• 2 Lund VJ. Malignant tumours of the nasal cavity and paranasal sinuses. ORL J Otorhinolaryngol Relat Spec 1983; 45 (01) 1-12
• 3 Ganly I, Patel SG, Singh B. et al. Craniofacial resection for malignant paranasal sinus tumors: report of an International Collaborative Study. Head Neck 2005; 27 (07) 575-584
• 4 Carrillo JF, Güemes A, Ramírez-Ortega MC, Oñate-Ocaña LF. Prognostic factors in maxillary sinus and nasal cavity carcinoma. Eur J Surg Oncol 2005; 31 (10) 1206-1212
• 5 Suarez C, Llorente JL, Fernandez De Leon R, Maseda E, Lopez A. Prognostic factors in sinonasal tumors involving the anterior skull base. Head Neck 2004; 26 (02) 136-144
• 6 Nazar G, Rodrigo JP, Llorente JL, Baragaño L, Suárez C. Prognostic factors of maxillary sinus malignancies. Am J Rhinol 2004; 18 (04) 233-238
• 7 Lisan Q, Kolb F, Temam S, Tao Y, Janot F, Moya-Plana A. Management of orbital invasion in sinonasal malignancies. Head Neck 2016; 38 (11) 1650-1656
• 8 Imola MJ, Schramm Jr VL. Orbital preservation in surgical management of sinonasal malignancy. Laryngoscope 2002; 112 (8 Pt 1): 1357-1365
• 9 Howard DJ, Lund VJ, Wei WI. Craniofacial resection for tumors of the nasal cavity and paranasal sinuses: a 25-year experience. Head Neck 2006; 28 (10) 867-873
• 10 Suárez C, Ferlito A, Lund VJ. et al. Management of the orbit in malignant sinonasal tumors. Head Neck 2008; 30 (02) 242-250
• 11 Hall SF, Rochon PA, Streiner DL, Paszat LF, Groome PA, Rohland SL. Measuring comorbidity in patients with head and neck cancer. Laryngoscope 2002; 112 (11) 1988-1996
• 12 Kim JH, Lee YS, Chung YS. et al. Treatment outcomes of concurrent chemoradiotherapy for locally advanced sinonasal squamous cell carcinoma: a single-institution study. Acta Otolaryngol 2015; 135 (11) 1189-1195
• 13 Piccirillo JF, Vlahiotis A. Comorbidity in patients with cancer of the head and neck: prevalence and impact on treatment and prognosis. Curr Oncol Rep 2006; 8 (02) 123-129
• 14 Neel GS, Nagel TH, Hoxworth JM, Lal D. Management of orbital involvement in sinonasal and ventral skull base malignancies. Otolaryngol Clin North Am 2017; 50 (02) 347-364
• 15 Dulguerov P, Jacobsen MS, Allal AS, Lehmann W, Calcaterra T. Nasal and paranasal sinus carcinoma: are we making progress? A series of 220 patients and a systematic review. Cancer 2001; 92 (12) 3012-3029