A Clinical Study of Squamous Cell Carcinoma of the Maxillary Sinus / 대한이비인후과학회지

ABSTRACT

BACKGROUND: Because the maxillary sinus is anatomically located adjacent to the orbit and skull base, it is difficult to remove the tumor completely with tumor-free margin in advanced maxillary cancer. Local recurrence is by far the most common cause of treatment failure and long-term survival rates are low. OBJECTIVES: By analyzing clinical status, treatment methods and results about squamous cell carcinoma of the maxillary sinus, the authors investigated local recurrences and survival rates by treatment and got helps from these evaluation and treatment. MATERIALS AND METHODS: Sixty-nine cases with squamous cell carcinomas of the maxillary sinus diagnosed at Department of Otolaryngology-Head and Neck Surgery, Korea Cancer Center Hospital from January 1989 to December 1995 were studied by chart review, telephone interview and letters retrospectively. RESULTS: The T-stages at presentation were T2 11.6%, T3 24.6%, T4 63.8% respectively, and overall neck node metastases were 8.7%. Thirty nine cases were treated with surgery at first choice of treatment and almost all cases were followed by adjunctive radiotherapy. Thirty cases were treated with radiotherapy at first choice of treatment. Overall recurrence rates were 75.4% and local recurrence rates were 72.4%. The sites of local recurrence treated by surgery were substantially higher in posterior wall of maxillary sinus, orbital floor, skull base and palate. The five-year survival rate by Kaplan-Meier method was 44.0% for surgery with radiotherapy and 16.8% for radiotherapy alone. CONCLUSION: Local recurrence was the major cause of treatment failure and the survival rates were poor. Therefore, early detection, aggressive local treatment and close follow up are desirable.