Prognostic analysis of 151 patients with maxillary sinus malignant neoplasms

BACKGROUND OBJECTIVE: Five-year survival rate of patients with m axillary malignant neoplasms is low, the prognostic factors of these neoplasms w ere unclear. This study was to investigate prognostic factors of maxillary sinus malignant neoplasms. METHODS: Records of 151 inpatients with malignant neoplasm s of maxillary sinus initially treated at Cancer Center of Sun Yat-sen Universi ty from Sep. 1983 to Mar. 1999 were reviewed. Of 151 cases, 72 were squamous cel l carcinoma (SCC), 44 were adenocarcinoma, 16 were sarcoma, and 19 were other hi stological types; according to 1997 UICC classification, 7 were stage Ⅱ, 55 wer e stage Ⅲ, and 89 were stage Ⅳ; 66 patients received combined therapy of surge ry and radiotherapy, 14 received surgery alone, 25 received radiotherapy alone, 39 received other treatments, and 7 gave up treatment. All patients were followe d up for more than 5 years. Influences of clinicopathologic factors on prognosis of patients with maxillary sinus malignant neoplasms were analyzed by Kaplan-M eier method, and Cox regression model with SPSS10.0 software. RESULTS: Five-yea r overall survival rate of patients of ≤40 years old was 55.7%, that of patien ts of 40 years old was 33.3%(P=0.030); that of patients with SCC was 30.2%, o f patients with adenocarcinoma was 57.5%, of patients with sarcoma was 24.3%, of patients with tumor of other histological types was 50.7%(P=0.011); that of patients with tumor of stage Ⅱ, Ⅲ, and Ⅳwere 85.7%, 45.8%, and 32.7%, resp ectively (P=0.029); that of patients with cervical metastases was 14.4%, of pat ients without cervical metastases was 44.1%(P=0.005); that of patients with dis tant metastases was 14.3%, of patients without distant metastases was 41.1%(P= 0.011); that of patients without treatment was 14.3%, of patients treated with surgery alone was 42.9%, of patients treated with radiotherapy alone was 32.3% , of patients treated with combined therapy of surgery and radiotherapy was 50.8 %, of patients treated with other treatments was 29.1%(P=0.004). Univariate su rvival analysis showed that the above 6 factors were prognostic factors of patie nts with maxillary sinus malignant neoplasms. Multivariate analysis showed that combination of surgery and radiotherapy (P=0.004, OR 1), clinical stage (P=0.02 5, OR 1), SCC (P=0.016, OR 1), and sarcoma (P=0.003, OR 1) were independent p rognostic factors of patients with maxillary sinus malignant neoplasms. CONCLUSI ON: For maxillary sinus malignant neoplasms, patients with SCC or sarcoma had po orer survival than patients with adenocarcinoma or other histological types of t umor; patients with sarcoma had poorer survival than patients with SCC. The high er the patients clinical stage was, the worse his prognosis was. Combination o f surgery and radiotherapy may be the best treatment for patients with maxillary sinus malignant neoplasms.