Marco Ferrari1, Alessandro Ioppi2, Alberto Schreiber3, Tommaso Gualtieri3, Davide Mattavelli3, Vittorio Rampinelli3, Stefano Taboni3, Michele Tomasoni3, Paolo Bossi4, Alberto Deganello3, Piero Nicolai5. 1. Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy; Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy. Electronic address: 1990marcoferrari@gmail.com. 2. Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy; Unit of Otorhinolaryngology - Head and Neck Surgery, University of Genoa, Genoa, Italy. 3. Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy. 4. Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy. 5. Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy.
Abstract
BACKGROUND: Maxillary sinus cancer is a rare disease with heterogeneous biologic behavior. The pattern of neurovascular invasion is known to be an important prognosticator in head and neck cancers, but has not been studied in maxillary malignancies. MATERIALS AND METHODS: Patients undergoing surgery-based treatment with curative intent for a malignancy of the maxillary sinus at the Unit of Otorhinolaryngology - Head and Neck Surgery of the University of Brescia between November 2000 and October 2018 were included. A description of the characteristics of the patients, tumors, and treatments has been performed along with uni- and multi-variate analysis of prognostic factors. Tumors were classified based on the presence of perineural (P0/P1) and lymphovascular invasion (V0/V1) in 4 categories: P0V0, P1V0, P0V1, and P1V1. RESULTS: One hundred-thirty-eight patients were included. Mean age at surgery was 61.0 years. Most patients (60.1%) were affected by non-salivary carcinomas, and most tumors (73.9%) were high-grade cancers. One hundred-seven (77.5%) tumors were classified as pT4. The large majority of patients received bi- or tri-modality treatment. Sixty-three (45.7%) cases were classified as P0V0, 32 (23.2%) as P1V0, 7 (5.1%) as P0V1, and 36 (26.1%) as P1V1. T category, nodal status, and neurovascular invasion were significantly associated with prognosis. Perineural and lymphovascular invasion were associated with the topographical growth of the tumor. CONCLUSIONS: Maxillary cancer is often diagnosed at an advanced stage and in most cases requires a multimodal approach. Perineural and lymphovascular invasion are frequent and have a different impact on prognosis and topographical extension of the tumor.
BACKGROUND:Maxillary sinus cancer is a rare disease with heterogeneous biologic behavior. The pattern of neurovascular invasion is known to be an important prognosticator in head and neck cancers, but has not been studied in maxillary malignancies. MATERIALS AND METHODS:Patients undergoing surgery-based treatment with curative intent for a malignancy of the maxillary sinus at the Unit of Otorhinolaryngology - Head and Neck Surgery of the University of Brescia between November 2000 and October 2018 were included. A description of the characteristics of the patients, tumors, and treatments has been performed along with uni- and multi-variate analysis of prognostic factors. Tumors were classified based on the presence of perineural (P0/P1) and lymphovascular invasion (V0/V1) in 4 categories: P0V0, P1V0, P0V1, and P1V1. RESULTS: One hundred-thirty-eight patients were included. Mean age at surgery was 61.0 years. Most patients (60.1%) were affected by non-salivary carcinomas, and most tumors (73.9%) were high-grade cancers. One hundred-seven (77.5%) tumors were classified as pT4. The large majority of patients received bi- or tri-modality treatment. Sixty-three (45.7%) cases were classified as P0V0, 32 (23.2%) as P1V0, 7 (5.1%) as P0V1, and 36 (26.1%) as P1V1. T category, nodal status, and neurovascular invasion were significantly associated with prognosis. Perineural and lymphovascular invasion were associated with the topographical growth of the tumor. CONCLUSIONS: Maxillary cancer is often diagnosed at an advanced stage and in most cases requires a multimodal approach. Perineural and lymphovascular invasion are frequent and have a different impact on prognosis and topographical extension of the tumor.
Authors: Stefano Taboni; Marco Ferrari; Michael J Daly; Harley H L Chan; Donovan Eu; Tommaso Gualtieri; Ashok R Jethwa; Axel Sahovaler; Andrew Sewell; Wael Hasan; Ilyes Berania; Jimmy Qiu; John de Almeida; Piero Nicolai; Ralph W Gilbert; Jonathan C Irish Journal: Front Oncol Date: 2021-11-11 Impact factor: 6.244