Sinonasal Non–Intestinal-Type Adenocarcinoma: A Retrospective Review of 22 Patients

• Published in: World neurosurgery Vol. 120; pp. e962 - e969
• Main Authors: Bignami, Maurizio, Lepera, Davide, Volpi, Luca, Lambertoni, Alessia, Arosio, Alberto, Pistochini, Andrea, Nicolai, Piero, Castelnuovo, Paolo
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2018
• Subjects: Adenocarcinoma - diagnosis; Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - therapy; Adult; Aged; Aged, 80 and over; Combined Modality Therapy; Endoscopic surgery; Female; Follow-Up Studies; Humans; Male; Middle Aged; Natural Orifice Endoscopic Surgery; Non–intestinal-type adenocarcinoma; Paranasal Sinus Neoplasms - diagnosis; Paranasal Sinus Neoplasms - mortality; Paranasal Sinus Neoplasms - pathology; Paranasal Sinus Neoplasms - therapy; Prognosis; Retrospective Studies; Sinonasal adenocarcinoma; Sinonasal malignancies; Skull base; Endoscopic surgery; RT; Non–intestinal-type adenocarcinoma; Sinonasal adenocarcinoma; Skull base; OS; DSS; Sinonasal malignancies; NED; ER; ITAC; CER; CT; ERTC; n-ITAC; RFS
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2018.08.201

To analyze outcomes and prognostic factors of sinonasal nonsalivary non–intestinal-type adenocarcinoma (n-ITAC.) A retrospective review of 22 consecutive patients with n-ITAC was performed. Average follow-up time was 77 months. The 5-year overall survival and disease-specific survival were 95.2%. The 5-year overall survival and disease-specific survival were 100% for pT1, pT2, and pT3 tumors and 83.3% for pT4a and pT4b tumors; 100% for G1 tumors and 87.5% for G3 tumors; and 100% for tumors with negative surgical margin and 50% for tumors with positive surgical margin. Stage, grade, and surgical margins were independent prognostic factors. Adjuvant radiotherapy was performed for high-grade and high-stage tumors. Surgery followed by radiotherapy has remained a mainstay for management of n-ITAC, and the endoscopic transnasal approach, when correctly planned and indicated, is the surgery of choice. Adjuvant radiotherapy is recommended in cases of high-stage (T3 and T4) and high-grade tumors. n-ITAC is associated with a favorable outcome. High grade, pT4 stage, and positive surgical margins are independent negative prognostic factors. •ITAC and n-ITAC are different diseases that should be analyzed independently.•Surgery followed by radiation has remained a mainstay in management of n-ITAC.•A tumor-free resection margin is of utmost importance regardless of surgical approach.•The endoscopic transnasal approach, when correctly planned and indicated, has low morbidity and mortality.