Elective neck treatment in clinically node-negative paranasal sinus carcinomas: impact on treatment outcome

PURPOSE: The indication of elective neck treatment (ENT) for clinically N0 (cN0) paranasal sinus (PNS) carcinoma remains unclear. We aimed to investigate different treatment outcomes regarding ENT and propose optimal recommendations for ENT. MATERIALS AND METHODS: We identified patients with cN0 PNS carcinoma who underwent curative-intent treatment between 1992 and 2015. Survival outcomes and pattern of failure were compared between patients who received ENT and those who did not. We sought to identify significant patient or pathologic factors regarding treatment outcomes. RESULTS: Among 124 patients meeting the inclusion criteria, 40 (32%) received ENT (‘ENT (+) group’) and 84 (68%) did not (‘ENT (−) group’). With a median follow-up of 54 months, the 5-year overall survival (OS) was 67%, and the 5-year progression-free survival (PFS) was 45%. There was no significant difference between the ENT (+) and ENT (−) groups regarding OS (p = 0.67) and PFS (p = 0.50). Neither group showed a significantly different pattern of failure, including regional failure (p = 0.91). There was no specific benefit, even in the subgroups analysis by tumor site, histologic type, and T stage. Nevertheless, patients who ever had regional and/or distant failure showed significantly worse prognosis. CONCLUSION: ENT did not significantly affect the survival outcome or pattern of failure in patients with cN0 PNS carcinomas, showing that ENT should not be generalized in this group. However, further discussion on the optimal strategy for ENT should continue because of the non-negligible regional failure rates and significantly worse prognosis after regional failure events.

Expression of C-X-C chemokine receptor type 7 in otorhinolaryngologic neoplasms

<p><b>INTRODUCTION</b>C-X-C chemokine receptor type 7 (CXCR7) has recently been characterised as a novel receptor for the C-X-C motif chemokine 12 (CXCL12)/stromal cell-derived factor 1-alpha. CXCR7 has been thought to play an important role in the pathogenesis of chronic rhinosinusitis, angiogenesis and tumour metastasis. The present study aimed to examine the expression of CXCR7 in tissue samples of laryngeal cancer and maxillary sinus carcinoma to determine its role in the development of otorhinolaryngologic neoplasms.</p><p><b>METHODS</b>Samples of otorhinolaryngologic neoplasms were obtained from 17 patients with either nasal polyps (n = 7), laryngeal cancer (n = 5) or maxillary sinus carcinoma (n = 5), and who underwent surgical resection at West China Hospital of Sichuan University. Total RNA was isolated and CXCR7 mRNA expression was examined and quantified by relative real-time reverse transcription polymerase chain reaction. A one-way analysis of variance was performed using SPSS Statistics version 11.0 (SPSS Inc, Chicago, IL, USA) to compare the CXCR7 mRNA levels among the three groups of patients.</p><p><b>RESULTS</b>All samples tested positive for CXCR7 mRNA. The quantitative results showed that the CXCR7 mRNA levels were highest in laryngeal cancer and lowest in maxillary sinus carcinoma neoplasms, although there was no significant difference among the three samples.</p><p><b>CONCLUSION</b>CXCL12 and its receptor CXCR7 may contribute to eosinophilic inflammation in patients with chronic sinusitis and nasal polyps. Our results also suggest that CXCR7 may play a role in the progression, metastasis and angiogenesis of otorhinolaryngologic tumours.</p>

Maxillary Sinus Carcinoma Initially Mistaken for Morpheaform Basal Cell Carcinoma / 대한피부과학회지

Squamous cell carcinoma (SCC) of the maxillary sinus is the most common malignant neoplasm of the paranasal cavity. The most frequent initial symptoms are swelling of the cheek, nasal obstruction, epistaxis, and nasal discharge. Herein, we report the case of a 62-year-old Korean male who initially presented with a whitish irregular depressed plaque with an indurated border in his left cheek. After a several-week delay in diagnosis, he was eventually diagnosed with maxillary sinus carcinoma.

Treatment and prognostic factors in 74 patients with maxillary sinus carcinoma / 中国癌症杂志

Purpose:To study treatment and prognostic factors in 74 patients with maxillary sinus carcinoma to improve methods of treatment. Methods:From January 1985 to December 1995,74 patients with maxillary sinus carcinoma were treated in our hospital.There were 46 males and 28 females,with a median age at diagnosis of 55 years(25-76 years),the tumor histology included squamous cell carcinoma ,adenocarcinoma,undifferentiated carcinoma (found in 55,8,11 patients).Using the AJCC method of classication,T 2 4 cases,T 3 32 cases and T 4 38 cases.Twenty of 74 patients had cervical lymphadenopathy at initial presentation,fifteen of 20 patients were in ipsilateral upper neck.Total dose was 50 Gy/28 f/41 d-78 Gy/39 f/55 d.Forty three patients had radiotherapy alone,thirty one had surgical resection and radiotherapy. Kaplan Meier and Log Rank test were used for evaluating the results of the local control and survival rates in this series,the multivariate parameters were analyzed by Cox model. Results:The 5 year survival rates were 33.9% for all patients.The 5 year loss of control rates of primary site were 56.2%,the 5 year neck failurs rates were 20.0%,the 5 year metastatic rates were 19.7%.The 5 year survival rates for radiothery alone, combined therapy were 16.4% and 56.1% respectively( P =0.0003).Of the 54 patients with N 0 disease,7 had neck recurrence,of the 7 neck failure,5 were in ipsilateral upper neck.The 5 year survival rates for patients who remained N 0 were 41.9% and for those [N(+) group] with initial cervical involvement or recurred in the neck were 20%( P =0.0076). Conclusions:Primary local failure is the most cause of therapeutic failure, the neck failure is in ipsilateral upper neck in many patients whose prognosis is poor,combined treatment is beneficial in maxillary sinus carcinoma.

The Detection of Human Papillomavirus and Epstein-Barr Virus DNA in Maxillary Sinus Carcinoma by Polymerase Chain Reaction / 대한이비인후과학회지

OBJECTIVES: Maxillary sinus carcinoma is rare when compared with cancers of other sites, and its etiology remains unknown. Recent reports demonstrate the possible etiologic role of human papillomavirus (HPV) and Epstein-Barr virus (EBV) in maxillary sinus carcinoma. The aim of this study is to detect HPV and EBV in the maxillary sinus carcinoma and examine the relationship between HPV, EBV and maxillary sinus carcinoma. We also compared the clinical features of patients with HPV-positive and HPV-negative to determine the clinical significance of HPV. MATERIALS AND METHOD: The authors retrospectively searched for HPV and EBV in 40 cases of maxillary sinus carcinoma by using the polymerase chain reaction (PCR) on DNA extracted from formalin-fixed, paraffin-embedded tissues. RESULTS: HPV was detected in 5 of the 40 cases (12.5%) of maxillary sinus carcinoma, whose histological type was all squamous cell carcinoma. EBV was not detected. Among the five HPV-positives, three were HPV subtype 16 and two were not determined. CONCLUSION: HPV may play a role in the pathogenesis of maxillary sinus carninoma, but EBV needs further study. However, the presence of HPV is not related to T-category, cervical metastases, or local recurrence.

Comparison of Results according to the treatment Method in Maxillary Sinus Carcinoma / 대한치료방사선과학회지

PURPOSE: A retrospective analysis was performed to investigate the proper management of maxillary sinus carcinoma. MATERIALS AND METHODS: Authors analysed 33 patients of squamous cell carcinoma of maxillary sinus treated at Chonnam University Hospital from January 1986 to December 1992. There were 24 men and 9 women with median age of 55 years. According to AJCC TNM system of 1988, a patient of T2, 10 patients of T3 and 22 patients of T4 were available, respectively. Cervical lymph node metastases was observed in 5 patients(N1;4/33, N2b;1/33). Patients were classified as 3 groups according to management method. The first group, named as "FAR" (16 patients), was consisted of preoperative intra-arterial chemotherapy with5-fluorouracil(5-FU;mean of total dosage;3078mg) through the superficial temporal artery with concurrent radiation(mean dose delivered;3433cGy, daily 180-200cGy) and vitamin A(50,000 IU daily), and followed by total maxillectomy and postoperative radiation therapy(mean dose;2351cGy). The second group, named as "SR"(7 patients), was consisted of total maxillectomy followed by postoperative radiation therapy(mean dose 5920 cGy). Her third group, named as "R"(6 patients), was treated with radiation alone(mean dose;7164cGy). Kaplan-Meier product limit method was used for survival analysis and Mantel-Cox test was performed for significance of survival difference between two groups. RESULTS: Local recurrence free survival rate in the end of 2 year was 100%, 5-% and 0% in FAR, SR and R group, repectively. Disease free survival rate in 2 years was 88.9%, 40% and 50% in Far, SR and R group, respectively. There were statistically significant difference between FAR and SR or FAR and R group in their local recurrence free, disease free and overall survival rates. But diffeence of each survival rate between SR and R group was not significant. CONCLUSION: In this study FAR group revealed better results that SR or R group. In the future prospective randomized study is in need.