Prognostic factors in paranasal sinus cancer

This study was designed to evaluate the influence of several different prognostic factors in determining both local recurrence rates and survival in patients treated for carcinoma of the paranasal sinuses.

A retrospective study of patients treated between January, 1975 and December, 1991 was undertaken. Hospital charts were reviewed collecting demographic, clinical, and radiographic findings, which were correlated with treatment and subsequent follow-up.

Carcinoma of the paranasal sinuses was identified in 129 patients. This included 95 men and 34 women with an average of 59 years. The ethmoid sinus was primarily involved in 50 patients, the maxillary sinus and 49, the nasal sinus and 25, sphenoid sinus in three in the frontal sinus and two patients. Advanced stage (T3/T4) was diagnosed in 60% of patients at presentation. The most commonly encountered histologies were squamous-cell carcinoma and adenocarcinoma. The most accurate predictors of poor prognosis were advanced T stage and involvement of the anterior skill base. Involvement of the posterior wall of the maxillary sinus, infratemporal fossa, and erosion of the orbital wall was not associated with the worst prognosis.

In spite of advances in imaging technique and surgical therapy, the primary cause of death is inability to control local disease. Diagnosis at an earlier stage is associated with improved outcome.