[New clinical staging system for carcinoma of nasal cavity].

OBJECTIVE: To establish a new staging system based on analysis of several presently used clinical staging systems for carcinoma of nasal cavity. METHODS: The data of 122 patients treated from 1985 to 1997 in the cancer center of Sun Yat-sen University were analyzed, and a new clinical staging system was established using computer optimizing and screening combined with the clinical results. The survival analysis was performed by Kaplan-Meier estimates, and the multivariate analysis was achieved by Cox proportional hazard model. RESULTS: The flaws in the presently used clinical staging systems proposed by Zhuang, Qiu, Department of Head and Neck of Cancer Center of Sun Yat-sen University and University of Florida and the AJCC'2002, were as follows: insufficient consideration of the modern tomography resulting in indefinite location of the tumor in clinical practice, the uneven distribution of patients in different stages, being unable to separate survival curves of different stages, and not containing of all necessary clinical staging information in some staging systems. However, based on our new staging system, the cases distributed in T1, T2, T3 and T4 was 16, 32, 42 and 32, and the 5-year survival rate was 78.8%, 64.6%, 49.9% and 30.0%, respectively. The cases distributed in stage I, II, III and IV was 16, 26, 45 and 35, and the 5-year survival rate was 78.8%, 68.4%, 51.3% and 29.0%, respectively. The overall 5-year survival rate was 61.6%. CONCLUSION: Compared to the presently used clinical staging systems, the new staging system may have more advantages in various parameters for the clinical staging in the carcinoma of nasal cavity, and may be worth to be widely and clinical used.

[Cancer of the nasal cavity].

OBJECTIVE: To analyze the factors affecting prognosis of patients with nasal carcinoma. METHODS: 163 patients treated from 1985 to 1998 were analyzed. The survival analysis was performed by Kaplan-Meier estimate and the comparison between groups by Log-rank test. Multivariate analysis was carried out by Cox proportional hazard model. RESULTS: The overall 5-year survival rate was 58.2%. The 5-year survival rate was 55.8% in squamous-cell carcinoma, 44.0% in adenocarcinoma, 59.7% in undifferentiated carcinoma, 76.3% in adenoid cystic carcinoma, 71.4% in mucoepidermoid carcinoma, 25.0% in rhabdomyosarcoma, 26.7% in malignant melanoma, 50.0% in neuroblastoma (P > 0.05). Patients with cervical metastasis gave a 5-year survival of 53.5% while those without gave 58.9% (P > 0.05). Patients with involvement of sphenoidal sinus or maxillary sinus gave the worse survival. The 5-year survival rate was 73.8% in patients whose cancer completely disappeared after treatment. It was 41.6% in patients whose cancer incompletely disappeared, and 34.3% in patients whose cancer remained refractory (P < 0.01). The 5-year survival was 78.3% in stage I disease, 56.4% in stage II disease, 54.2% in stage III and 35.9% in stage IV (P < 0.05). The 5-year survival rate of patients who were treated with radiotherapy only was 56.9%. That of patients who were treated with surgery only was 56.6%. That with chemotherapy only was 25.0% whereas that of patients treated with combination treatment was 61.8% (P > 0.05). So far, 85 patients have died up to writing this report, 57.6% (49 patients) of recurrence or uncontrolled. CONCLUSION: Clinical stage, immediate therapeutic response and involvement of sphenoidal or maxillary sinus; but not the pathologic type, the presence of cervical metastasis nor the method of treatment, are the factors affecting the prognosis of patients with nasal carcinoma. Recurrence and uncontrolled disease are the cause of death.

[Prognosis and treatment for 98 patients with carcinoma of nasal cavity].

BACKGROUND & OBJECTIVE: Carcinoma of nasal cavity is a rare disease without standard treatment. This study was designed to evaluate treatment outcome, and prognostic factors of patients with carcinoma of nasal cavity. METHODS: Records of 98 patients with carcinoma of nasal cavity were reviewed,43 patients received radiotherapy alone, 55 patients received surgery plus radiotherapy. Survival analysis was performed by Kaplan-Meier method,differences between groups were tested by log-rank test,multivariate analysis was carried out by Cox proportional hazard model. RESULTS: The overall 5-, and 10-year survival rates were 65.3%, and 37.1%. The 5-, and 10-year survival rates of patients with tumor of stage I, II were 87.3%, and 51.1%, those of patients with tumor of stage III, IV were 56.1%, and 32.2% (P=0.02). The patients with squamous cell carcinoma had lower survival rates than those with adenocarcinoma (P< 0.01). There was significant difference in survival rates between patients received radiotherapy alone and patients received radiotherapy plus surgery in advanced lesions (P=0.04) and in squamous cell carcinoma (P< 0.01), but not in early lesions (P=0.41) and in adenocarcinoma (P=0.73). Patients who were initially diagnosed cervical lymph node metastasis had a reduced survival rate compared with node-negative patients (P=0.01). In Cox's regression, clinical stage and node-positive were independent prognostic factors. CONCLUSIONS: The criteria should be taken into account when choosing treatment method for patients with carcinoma of nasal cavity: radiotherapy plus surgery is preferred for advanced lesions and for squamous cell carcinoma, radiotherapy alone is better for early lesions and for adenocarcinoma. Clinical stage, and node-positive may be independent prognostic factors of patients with carcinoma of nasal cavity.