Ali-Farid Safi1, Lars Behn2, Daniel Rothamel2, Orlando Guntinas-Lichius3, Dirk Beutner4, Hans-Joachim Nickenig2, Joachim Zöller2, Matthias Kreppel2. 1. Department for Oral and Maxillofacial Plastic Surgery (Head: Prof. Dr. Dr. J.E. Zöller), University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; Center of Integrated Oncology Cologne, 50937 Cologne, Germany. Electronic address: asafi@outlook.de. 2. Department for Oral and Maxillofacial Plastic Surgery (Head: Prof. Dr. Dr. J.E. Zöller), University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; Center of Integrated Oncology Cologne, 50937 Cologne, Germany. 3. Department of Oto-Rhino-Laryngology and Head Neck Surgery, Jena University Hospital, 07743 Jena, Germany. 4. Department of Oto-Rhino-Laryngology and Head Neck Surgery, University of Cologne, 50937 Cologne, Germany; Center of Integrated Oncology Cologne, 50937 Cologne, Germany.
Abstract
INTRODUCTION: Orbital invasion is a strong independent prognostic factor for sinonasal malignancies. While there is consent about preservation of the orbit for tumors limited to the orbital periosteum there is controversy about the optimal management of sinonasal malignancies transgressing this barrier. Therefore the aim of our study was to compare exenteration versus preservation of the orbit. MATERIAL AND METHODS: 52 patients with sinonasal malignancies invading the orbit beyond the orbital periosteum with involvement of the orbital soft tissues were included in the retrospective study. Prognostic factors were identified through univariate analysis. RESULTS: Univariate analysis revealed a significant impact of N-classification (p = 0.017), and treatment strategy (p = 0.016). Exenteration of the orbit was associated with a significantly better 5-year overall survival rate (65.5%) than preservation of the orbit (14%). CONCLUSIONS: For patients with invasion of the structures beyond the orbital periosteum, exenteration yields better survival results than preservation of the orbital structures in combination with radiotherapy. In cases where both eyes are affected from the tumor or if only one dysfunctional eye would be left over after therapy, we do not recommend orbital exenteration because life quality would be critically deteriorated.
INTRODUCTION: Orbital invasion is a strong independent prognostic factor for sinonasal malignancies. While there is consent about preservation of the orbit for tumors limited to the orbital periosteum there is controversy about the optimal management of sinonasal malignancies transgressing this barrier. Therefore the aim of our study was to compare exenteration versus preservation of the orbit. MATERIAL AND METHODS: 52 patients with sinonasal malignancies invading the orbit beyond the orbital periosteum with involvement of the orbital soft tissues were included in the retrospective study. Prognostic factors were identified through univariate analysis. RESULTS: Univariate analysis revealed a significant impact of N-classification (p = 0.017), and treatment strategy (p = 0.016). Exenteration of the orbit was associated with a significantly better 5-year overall survival rate (65.5%) than preservation of the orbit (14%). CONCLUSIONS: For patients with invasion of the structures beyond the orbital periosteum, exenteration yields better survival results than preservation of the orbital structures in combination with radiotherapy. In cases where both eyes are affected from the tumor or if only one dysfunctional eye would be left over after therapy, we do not recommend orbital exenteration because life quality would be critically deteriorated.
Authors: Fernando López; Jatin P Shah; Jonathan J Beitler; Carl H Snyderman; Valerie Lund; Cesare Piazza; Antti A Mäkitie; Orlando Guntinas-Lichius; Juan P Rodrigo; Luiz P Kowalski; Miquel Quer; Ashok Shaha; Akihiro Homma; Alvaro Sanabria; Renata Ferrarotto; Anne W M Lee; Victor H F Lee; Alessandra Rinaldo; Alfio Ferlito Journal: Adv Ther Date: 2022-03-30 Impact factor: 4.070