Recurrence of cancer of the paranasal sinuses after primary treatment – analysis of conditions and results of salvage treatment
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The aim of this study: is to demonstrate epidemiological and clinical parameters of the group of patients with sinonasal malignancies and to analyze its impact on development of recurrences after primary surgical treatment conducted in Head and Neck Surgery Department of Holly Cross Cancer Center Kielce during 7-years period 2001-2007. The retrospective analysis of the group of 42 patients with sinonasal malignancies was made, based on medical record and outpatient follow-up, considering: age, sex, primary focus, histological outcome, local and clinical stage and methods of the therapy. In the group of patients with at least 3-years period of follow-up (n=42) the dependence the rate of oncological failures such as local recurrence, nodal metastases, distant metastases or the second primary focus on clinical and epidemiological factors was analyzed. The probability of survival rate was also estimated. The studied group consists of 42 patients (27M, 15K, M:K =1.8:1). Age ranged from 28 to 87. The most common localization was maxillary sinus – 59.5%. Patients with high local (T3, T4) and clinical (III, IV) stage constitute 77,5% of the studied group. In 66.7% cases the radiation therapy had to follow the surgery. In the group of 42 patients with at least 3-years period of follow-up the oncological failure appeared in 17 cases (40.5%): local recurrence (8), nodal metastases (7), distant metastases (1) and all of them in 1 case. The treatment was performed through: local recurrence (surgery in 2 cases, CHTH – 3, symptomatic treatment – 3), nodal metastases (RND – 3, SND – 4, supplementary radiotherapy –7), distant metastases – CHTH – 2 cases. Thanks to these procedures the 5-year survival rate is 23.1% and the 3-year survival rate is 29.4%. Conclusions: 1. The oncological failure after primary surgical treatment in the group of patients with sinonasal malignancies developed in 40.5% cases, mainly as local recurrence or nodal metastases. 2. Primary localization and sex have no impact on the rate of the recurrence. 3. The oncological failures signifi cantly more often relate to young patients with high local, clinical stage and low grade of malignancies. 4. The recurrence after primary surgical treatment in the group of patients with sinonasal malignancies substantially reduces 3- and 5-year survival rate (29.4%; 23.1%) compared with the entire studied group – 54.8%; 40.0%.
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