Treatment of paranasal sinus cancer with cranial base surgery: results.

Paranasal sinus cancer has been difficult to treat with surgery. A significant negative factor has been the high frequency of tumor-positive surgical margins. The goal of this study was to evaluate the effectiveness of cranial base surgery in achieving higher tumor-free resective margins and its impact on the disease control. Fifty patients with paranasal sinus cancer were treated with cranial base surgery and retrospectively evaluated. Surgery was performed for both primary and recurrent disease ("salvage"), with more than half of the surgeries being salvage procedures. The survival at 40 months of mean follow-up is 74%, and 64% of the patients either have no evidence of disease (NED) or have died of other causes (DOC). Cranial base surgery is an effective treatment of paranasal sinus cancer. The ability to achieve tumor-free surgical margins (77% in squamous cell carcinoma [SCC]) is directly related to NED status (75% of NED patients had free margins).