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Squamous cell carcinoma of the maxillary sinus: a Tata Memorial Hospital experience
Sajid S Qureshi1, Devendra A Chaukar, Sanjay D Talole
1Department of Head and Neck Services, Tata Memorial Hospital, Parel,Mumbai - 400 012, India. sajidshafique@rediffmail.com
Background:
The optimal treatment of maxillary sinus carcinoma remains to be defined and there is a paucity of Indian studies on the subject.
Aims:
To present experience of management of squamous cell carcinoma of the maxillary sinus treated with curative intent at a single institution.
Settings And Design:
Retrospective study of patients with squamous cell carcinoma of the maxillary sinus who presented between 1994 to 1999.
Materials And Methods:
The records of 73 patients with squamous cell carcinoma of the maxillary sinus were analyzed. Sixty-two patients were evaluable. Forty patients (65%) were treated with surgery followed by postoperative radiotherapy, five patients (8%) were treated with radiotherapy alone, five patients (8%) were treated with surgery alone; 12 patients (19%) received chemotherapy.
Statistical Analysis Used:
Statistical analysis was done using Kaplan-Meier method.
Results:
The majority of patients presented with locally advanced disease (52, 84%); nodal involvement was observed in five patients (8%). The most common site of recurrence was at the primary site, which was observed in 28 patients (45%) and regional failures occurred in 10 (16%). The 3 and 5-year overall survival was 38% and 35% and the disease free survival was 29% and 26% respectively. The 5-year overall survival after surgery and postoperative radiotherapy was 42%.
Conclusions:
The majority of patients present with advanced disease resulting in poor outcomes to conventional treatment modalities. Locoregional tumor progression remains a significant pattern of failure. New approaches such as neoadjuvant or concomitant chemoradiotherapy with aggressive surgery need to be considered and evaluated in prospective studies.