Clinical Outcome in Patients with Large Sinonasal Tumors with Intracranial Extension

Abstract

Malignant tumors of the sinonasal cavities with extension to the frontal skull base are rare and challenging pathologies. A combined-approach including frontobasal craniotomy, endoscopic sinus surgery with reconstruction of the anterior skull base, followed by adjuvant radiotherapy is our preferred treatment strategy in selected cases. Morbidity and mortality rates are high in this population. We performed a retrospective cross-sectional single center study of the long-term clinical outcome in our tertiary university referral hospital between 2010 and 2020. Patient, tumor, treatment, complications and survival characteristics of eighteen consecutive patients were extracted from the electronic health records. Descriptive statistics and frequency distributions were performed. Eighteen consecutive patients were included with a mean age of 61 (SD ± 10) years (range 38-80); ten males and eight females. Gross total resection was achieved in 14 (77%) patients. Eleven (61%) patients underwent local radiotherapy, one (5%) chemotherapy and three (17%) a combination of both. Mean follow-up duration was 49 months (range 3 – 138). Three (17%) patients died in the hospital due to post-operative complications. Six (33%) patients died during follow-up due to disease progression. Mean progression-free survival was 47 months (range 0 – 113). In conclusion, the overall survival was 50% for this group of patients with large sinonasal tumors. Progressive disease affects survival rate severely. Surgical complications were seen in five (28%) patients. Radiotherapy is associated with high complication rates. Radiation necrosis was a serious complication in two patients and could be treated with high dose steroids.