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16-01-2024 | Rhinology

Choice of surgery in intestinal-type adenocarcinoma of the sinonasal tract: a long-term comparative study

Authors: Tijl Vermassen, Stijn De Keukeleire, Michael Saerens, Sylvester Heerwegh, Jens M. Debacker, Wouter Huvenne, Philippe Deron, David Creytens, Liesbeth Ferdinande, Sylvie Rottey, Claus Bachert, Fréderic Duprez, Thibaut Van Zele

Published in: European Archives of Oto-Rhino-Laryngology | Issue 6/2024

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Abstract

Purpose

Intestinal-type adenocarcinoma (ITAC) is a rare sinonasal malignancy. Curative treatment requires multidisciplinary approach, with surgical options consist of the endonasal endoscopic approach (EEA) and external surgery (EXTS). Here, we provide the post-operative and survival results from a single-center long-term follow-up.

Methods

We report long-term follow-up of 92 ITAC cases treated between 1998 and 2018, treated with EEA (n = 40) or EXTS (n = 52). Survival estimates, post-operative complications and duration of hospitalization were compared between surgical modalities.

Results

Baseline characteristics were similar. A higher number of T4b tumors (16%), and subsequently more tumoral invasion (39%), was present in patients undergoing EXTS compared to EEA (3% and 18%, respectively). No difference in Barnes histology subtypes was noticed. Patients undergoing EEA had a shorter post-operative hospitalization stay versus EXTS (4 versus 7 days). Use of EEA was associated to improved disease-specific survival (DSS; 11.4 versus 4.4 years; HREEA = 0.53), especially for patients with T3–4a tumors (11.4 versus 3.0 years; HREEA = 0.41). Patients with T3–4 stage, tumoral invasion, positive surgical margins, mucinous or mixed histology, and prolonged post-operative hospital stay showed poor local relapse-free, disease-free, overall, and DSS.

Conclusions

Long-term follow-up in locally advanced ITAC demonstrates that resection by EEA is correlated with improved DSS compared to EXTS, especially for T3–4 tumors. No significant differences between both treatment modalities was observed regarding per- and post-operative complications, although hospitalization in patients undergoing EEA was shorter than for patients treated with EXTS. These results confirm that EEA should remain the preferred surgical procedure in operable cases of sinonasal ITAC.
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Metadata
Title
Choice of surgery in intestinal-type adenocarcinoma of the sinonasal tract: a long-term comparative study
Authors
Tijl Vermassen
Stijn De Keukeleire
Michael Saerens
Sylvester Heerwegh
Jens M. Debacker
Wouter Huvenne
Philippe Deron
David Creytens
Liesbeth Ferdinande
Sylvie Rottey
Claus Bachert
Fréderic Duprez
Thibaut Van Zele
Publication date
16-01-2024
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 6/2024
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-024-08447-w

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