[Proposal on T staging of maxillary sinus cancer]

The TNM staging of maxillary sinus cancer was stipulated by the UICC in 1987 using Ohngren line of demarcation. This report is to discuss the applicability of this staging based on 232 cases of maxillary sinus cancer treated in this hospital. Of 232 cases, the 3-year survival rate for those who received surgery alone was 4/6, for those after radical irradiation, 15.6% (20/128) and for those by combined irradiation and surgery, 43.9% (43/98). The 3-year survival rate for the whole series was 28.9%. To analyze the survival rates of different types of lesion separately, we found that those with involvement of the posterior wall, hence invading the pterygopalatine fossa had poor prognosis with a three year survival rate of 19.5%. And invasion of soft and/or hard palate also gave poor survival. Contrary to the common consensus, invasion of ethmoidal sinuses did not pose a serious prognosis. The feasibility of the Ohngren line in TNM staging was thus questioned. On the basis of our data, a modification of the TNM staging of JJC for maxillary sinus cancer is suggested.