Treatment Outcomes of Locally Advanced Squamous Cell Carcinoma of the Ethmoid Sinus Treated with Anterior Craniofacial Resection or Chemoradiotherapy

Abstract

We retrospectively analyzed 14 patients with locally advanced squamous cell carcinoma of ethmoid sinus (LASCC-ES) for the feasibility of anterior craniofacial resection (ACFR). Ethmoid cancer treatment comprised alternating chemoradiotherapy (ALCRT; n = 1), concomitant radiotherapy and intra-arterial cisplatin (RADPLAT; n = 4) and ACFR (n = 9). The 3- and 5-year overall survival (OS) rates of patients were 47.6 and 39.6%, respectively. The 3-year local control (LC) rates of chemoradiotherapy (CRT; ALCRT and RADPLAT) (n = 5) and ACFR (n = 9) groups were 0 and 66.7% (p = 0.012), respectively. The 3-year progression-free survival (PFS) rate of the CRT and ACFR groups were 0 and 55.6% (p = 0.018), respectively. The 3-year OS rate of the CRT and ACFR groups were 0 and 76.2% (p = 0.005), respectively. Postoperative pathological examinations confirmed positive margins in 3 (33%) of 9 cases. The 3-year LC and PFS rates of cases (n = 3) with positive surgical margins were significantly poorer than those of cases (n = 6) with negative surgical margins. Although ACFR for LASCC-ES is a feasible treatment, cases with positive surgical margins were more prone to local relapse. Therefore, surgical safety margins should be thoroughly assessed.

Prognostic Factors and Outcomes of De Novo Sinonasal Squamous Cell Carcinoma: A Systematic Review and Meta‐analysis

“…All 44 studies included information on survival data, with 35 (n = 1903) reporting on 5-year OS. 4,6-8,10,11,14-18,23-55 The weighted mean overall 5-year OS in this review was 54.5% (range, 18%-75%). Five-year OS data available on all patients undergoing surgery, open and endoscopic surgery, no surgery, radiation, surgery alone, surgery and RT, CT, and CT and RT are reported in Table 3 .…”

“…Eight studies provided 5-year OS rates of both surgery and no surgery, with 5-year OS rates of 56.7% and 47.4%, respectively. 17,18,29,45,47,48,51,54 Direct meta-analysis demonstrated patients with surgery were more likely to be alive at 5 years compared to those who did not receive surgery (OR, 2.26; 95% CI, 1.48-3.47; P < .001), with the observed survival difference occurring in the absence of study heterogeneity ( I 2 = 0) ( Figure 3 ). Figure 2 shows the funnel plot with a roughly asymmetrical distribution, signaling the presence of publication bias among the 8 studies included in the meta-analysis.…”

“…All 44 studies included information on survival data, with 35 (n = 1903) reporting on 5‐year OS 4,6–8,10,11,14–18,23–55 . The weighted mean overall 5‐year OS in this review was 54.5% (range, 18%‐75%).…”

“…Given the paucity of studies providing survival data comparing similar outcomes, our meta‐analysis was limited to comparing survival data between patients receiving surgery and no surgery. Eight studies provided 5‐year OS rates of both surgery and no surgery, with 5‐year OS rates of 56.7% and 47.4%, respectively 17,18,29,45,47,48,51,54 . Direct meta‐analysis demonstrated patients with surgery were more likely to be alive at 5 years compared to those who did not receive surgery (OR, 2.26; 95% CI, 1.48‐3.47; P <.…”