Cell carcinoma of the paranasal sinuses and skull base

McKay, Shawn P.; Shibuya, Terry Y.; Armstrong, William B.; Wong, Hau-Sin; Panossian, Apraham M.; Ager, Joel; Mathog, Robert H.

doi:10.1016/j.amjoto.2006.09.007

« Previous Next »American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 28, Issue 5 , Pages 294-301, September 2007

Cell carcinoma of the paranasal sinuses and skull base

Presented in part as a poster at Triological Meeting, Middle Section, San Diego, CA, February 2-5, 2006.

Shawn P. McKay
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
Terry Y. Shibuya
- Department of Otolaryngology/Head and Neck Surgery, University of California Irvine School of Medicine, Orange, CA, USA
William B. Armstrong
- Department of Otolaryngology/Head and Neck Surgery, University of California Irvine School of Medicine, Orange, CA, USA
Hau-Sin Wong
- Department of Otolaryngology/Head and Neck Surgery, University of California Irvine School of Medicine, Orange, CA, USA
Apraham M. Panossian
- Department of Otolaryngology/Head and Neck Surgery, University of California Irvine School of Medicine, Orange, CA, USA
Joel Ager
- Center for Healthcare Effectiveness Research, Wayne State University School of Medicine, Shiffman Medical Library, Detroit, MI, USA
Robert H. Mathog
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
- Corresponding author. Wayne State University School of Medicine, 5E UHC, 4301 St Antoine, Detroit, MI 48202, USA. Tel.: +1 313 577 0804; fax: +1 313 577 8555.

Received 14 June 2006

Abstract

Purpose

To evaluate patients with squamous cell carcinoma of the paranasal sinus and skull base for factors that might predict clinical outcome.

Methods

A multi-institutional 13-year retrospective review of anterior skull base malignancies.

Results

Of 73 patients with anterior skull base malignancies, squamous cell carcinoma was the most prevalent—30 patients or 41%. Twenty-three patients underwent craniofacial surgery with or without adjuvant chemotherapy. Seven patients, deemed unresectable or not willing to have surgery, were treated with standard radiation protocols often with chemotherapy. The 3- and 5-year survival rates after surgery were 32% and 16%, respectively, compared to a 28% survival rate at 3 and 5 years for the nonsurgical group. Most tumors were in advanced stages accounting for a relatively poor survival in both groups. A Cox regression analysis demonstrated that age (P = .0172) was an independent determinant of poor outcome. Although 3- and 5-year survival of tumors free of sphenoid sinus, dura, retromaxillary, and ptyerygoid space, and orbit treated with surgery showed no significant difference to those patients with involvement, their median time of survival was increased for all anatomical regions.

Conclusions

Squamous cell carcinoma of the sinus invading the skull base carries a very poor prognosis regardless of treatment modality. Surgery with adjunctive radiotherapy and/or chemotherapy offers a survival advantage over nonsurgical methods, but treatment should be individualized weighing prognostic factors, such as age, stage, and anatomical extension with morbidity of treatment.