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Transfacial versus endoscopic approach in the treatment of woodworker's nasal adenocarcinomas
Rémy Grosjean1, Patrice Gallet, Cédric Baumann
1Head and Neck Surgery, CHU, de Nancy-Hôpital Central, Nancy, France; University of Lorraine, Nancy, France.
Background:
The purpose of this study was to present a monocentric retrospective study designed to compare oncologic results and morbidity between transfacial surgery and endoscopic endonasal surgery for nasal adenocarcinomas.
Methods:
Between 1998 and 2003, 31 patients were operated on via transfacial surgery, and between 2004 and 2009, 43 patients were operated on via endoscopic endonasal surgery. Overall and specific survival, local control, and morbidity (length of hospitalization, intensive care unit [ICU] monitoring, need for nasal packing, and complications) were compared.
Results:
There was no difference in prognostic factors between groups, but the median age was significantly higher for endoscopic endonasal surgery. Three-year overall survival, specific survival, and local control were not different between groups (respectively, 76.7%, 86%, and 81.4% for endoscopic endonasal surgery vs 61.3%, 67.7%, and 71% for transfacial surgery). Morbidity was significantly lower with endoscopic endonasal surgery for all criteria.
Conclusion:
Endoscopic surgery may replace transfacial surgery in the treatment of woodworker's adenocarcinomas. Older patients can be operated on by decreasing morbidity and mortality with at least similar oncologic results.
Insights
Endoscopic endonasal surgery offers similar oncologic outcomes to transfacial surgery for nasal adenocarcinomas but with significantly reduced morbidity. This approach is particularly beneficial for older patients, improving outcomes and safety.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Rhinology
Background:
- Nasal adenocarcinomas present a complex treatment challenge.
- Transfacial surgery and endoscopic endonasal surgery are established treatment modalities.
- Comparing oncologic outcomes and patient morbidity is crucial for treatment selection.
Purpose of the Study:
- To compare oncologic results and morbidity between transfacial surgery and endoscopic endonasal surgery for nasal adenocarcinomas.
- To evaluate the efficacy and safety of endoscopic endonasal surgery as an alternative to transfacial surgery.
Main Methods:
- A monocentric retrospective study comparing 31 patients treated with transfacial surgery (1998-2003) and 43 patients treated with endoscopic endonasal surgery (2004-2009).
- Key outcomes assessed included overall and specific survival, local control, and various morbidity indicators such as hospitalization length, ICU monitoring, nasal packing, and complications.
Main Results:
- No significant differences in prognostic factors were observed between the two surgical groups.
- Three-year overall survival, specific survival, and local control rates were comparable between endoscopic endonasal surgery and transfacial surgery.
- Endoscopic endonasal surgery demonstrated significantly lower morbidity across all measured criteria, including reduced hospitalization, ICU stay, and need for nasal packing.
Conclusions:
- Endoscopic endonasal surgery presents a viable alternative to transfacial surgery for treating nasal adenocarcinomas, including those in woodworkers.
- This minimally invasive approach allows for decreased morbidity and mortality in older patients while achieving comparable oncologic results.
