Recurrence Patterns of the Maxillary Sinus Cancer after Total Maxillectomy

ABSTRACT

BACKGROUND AND OBJECTIVES: Maxillary sinus is anatomically located adjacent to the orbit and the skull base, so, in cases of advanced maxillary sinus cancer, it is difficult to completely remove the tumor with sufficient resection margins. Local recurrence is by far the most common cause of treatment failure and the long-term survival rates is low. The purpose of this study is to analyze the treatment outcomes and recurrence patterns of the advanced squamous cell carcinoma of the maxillary sinus after total or radical maxillectomy. SUBJECTS AND METHODS: A group of twenty patients who underwent total or radical maxillectomy for advanced squamous cell carcinoma of the maxillary sinus between 1995 and 2004 were examined. The medical records and radiologic findings of the same 20 patients were retrospectively reviewed. RESULTS: Eleven patients suffered from recurrence during the follow-up period. Isolated local recurrence was most common, and all local recurrences developed within 2 years after the treatment. The most common site of recurrence was the cheek. However, there was no significant difference in the recurrence rate in relation to the degree of tumor differentiation, concurrent inverted papilloma, existence of orbital involvement, the type of maxillectomy, and combined treatment. CONCLUSION: Despite the combined use of surgery and radiotherapy, prognosis of squamous cell carcinoma of the maxillary sinus is very poor as the recurrence rate is 55% within the post-treatment 2 years. Failure at the primary site is the main problem. Chemotherapy was ineffective for the recurred cases, so rescue surgery should be considered for the recurred cases, if resectable