Squamous carcinoma of the nasal cavity and paranasal sinuses

Article Abstract:

The intricate anatomy of the nose is a problem in the treatment of cancer located in the nasal cavity and paranasal sinuses. In addition, early symptoms are often ignored, therefore many patients are in advanced stages of the disease when first treated. Five-year survival patterns vary according to the location of the primary tumor and the method of treatment. The medical records of 105 patients with malignant tumors who were treated from January 1966 to December 1982 were retrospectively analyzed to determine the correlations among the location of the tumor, method of therapy and five-year cure rate. The patients (70 males and 35 females) ranged in age from 27 to 81 years (median age was 60 years). The tumor was in the maxillary sinus in 65 patients (62 percent), in the nasal cavity in 27 patients (26 percent), in the ethmoid sinus in 11 patients (10 percent), and in the sphenoid sinus in 2 patients (2 percent). Either surgery or radiotherapy was performed on over 50 percent of the patients, and the remaining patients received a combination of surgery and radiation. The five-year cure rate was 37 percent for all the patients, but patients with nasal cavity and maxillary sinus tumors had the highest rates at 45 and 38 percent, respectively. The lowest cure rate (13 percent) was found in ethmoid sinus tumor cases, and one out of two sphenoid cancer patients was alive after five years. Local recurrence of the cancer seemed to be a common problem, but the recent development and improvement of computed tomography scanning will be useful in determining the exact extent of the tumor. In addition, modified procedures using a combination of chemotherapy, radiation and surgery (trimodal therapy) to treat nasal and sinus carcinoma may increase the cure rate and decrease the need for radical surgical treatment alone. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Case studies, Prognosis, Squamous cell carcinoma, Head and neck cancer, Nose cancer

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Significance of positive margins in oral cavity squamous carcinoma

Article Abstract:

There is an implication of significantly higher risk of recurrence and poor prognosis when the final pathology report indicates the presence of cancer in the surgical margin of the removed tumorous tissue. In patients with squamous cell carcinoma of the head and neck, it is difficult to quantify the risk of recurrence related to a cancerous (involved) margin, because reports deal with small numbers of patients. The value of adjuvant (additional) postoperative radiotherapy when the surgical margin is positive has also not been determined. A retrospective review of 389 patients undergoing surgery for cancer of the oral cavity were reviewed. Surgery was performed between 1979 and 1983. Positive margins were identified in 129 patients. Five-year survival for all patients was 57 percent; for patients with negative surgical margins it was 60 percent, and for patients with positive surgical margins it was 52 percent. This difference was statistically significant. Patients with positive surgical margins had an incidence of local recurrence that was twice that of patients with negative margins. Metastasis (spread) to the neck or other areas of the body was not significantly influenced by the status of surgical margins. Of the 129 surgical patients, 49 had postoperative radiotherapy; these patients showed a trend toward lower recurrence rates, but this was not statistically significant. It is concluded that it is important that the primary tumor be adequately resected to provide negative surgical margins. Postoperative radiotherapy appears to be ineffective in controlling cancer recurrence in patients with positive surgical margins. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Surgery, Cancer, Radiotherapy, Mouth cancer, Histology, Pathological, Pathological histology

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