TY - JOUR
T1 - Clinical and biological prognostic factors in 179 cases with sinonasal carcinoma treated in the italian piedmont region
AU - Airoldi, Mario
AU - Garzaro, Massimiliano
AU - Valente, Guido
AU - Mamo, Carlo
AU - Bena, Antonella
AU - Giordano, Carlo
AU - Pecorari, Giancarlo
AU - Gabriele, Pietro
AU - Gabriele, Anna Maria
AU - Beatrice, Fabio
PY - 2009/3
Y1 - 2009/3
N2 - Objectives: In spite of aggressive surgery and high-dose radiotherapy, the long-term survival of patients with sinonasal cancer remains disappointing. In this paper, we report data from 179 consecutive cases treated in the Italian Piedmont region between 1996 and 2000 according to a fixed protocol. Methods: Clinical and pathological data and the following biological parameters were analyzed: microvessel density and growth fraction by CD31 and Ki-67 positivity, respectively, and immunohistochemical expression of vascular endothelial growth factor (VEGF). Results: The median follow-up period was 75 months (range 45-108 months). Median overall survival was 26 months; 2- and 5-year overall survival rates were 52 and 36%, respectively. Patients with T1-T2 adenocarcinoma and squamous cell cancers (SCC) had better median survival than those with other lesions (p <0.05). Patients treated with surgery with or without radiotherapy had better survival (p <0.01), while chemotherapy had a marginally favorable effect (p = 0.09). The type of surgery and radiotherapy dose had no impact on survival; in contrast, there was a strong association between Ki-67 expression and microvessel density and overall survival (p <0.05 and p = 0.039, respectively), while VEGF-C was a prognostic factor in SCC patients only (p <0.05). Conclusions: In sinonasal cancer, tumor stage and histology have a clear impact on survival; surgery with or without radiotherapy represents the main choice of treatment for such tumors. The efficacy of neoadjuvant and concomitant chemoradiotherapy needs to be further investigated. The proliferative index and angiogenesis show a major role in the natural history of this cancer.
AB - Objectives: In spite of aggressive surgery and high-dose radiotherapy, the long-term survival of patients with sinonasal cancer remains disappointing. In this paper, we report data from 179 consecutive cases treated in the Italian Piedmont region between 1996 and 2000 according to a fixed protocol. Methods: Clinical and pathological data and the following biological parameters were analyzed: microvessel density and growth fraction by CD31 and Ki-67 positivity, respectively, and immunohistochemical expression of vascular endothelial growth factor (VEGF). Results: The median follow-up period was 75 months (range 45-108 months). Median overall survival was 26 months; 2- and 5-year overall survival rates were 52 and 36%, respectively. Patients with T1-T2 adenocarcinoma and squamous cell cancers (SCC) had better median survival than those with other lesions (p <0.05). Patients treated with surgery with or without radiotherapy had better survival (p <0.01), while chemotherapy had a marginally favorable effect (p = 0.09). The type of surgery and radiotherapy dose had no impact on survival; in contrast, there was a strong association between Ki-67 expression and microvessel density and overall survival (p <0.05 and p = 0.039, respectively), while VEGF-C was a prognostic factor in SCC patients only (p <0.05). Conclusions: In sinonasal cancer, tumor stage and histology have a clear impact on survival; surgery with or without radiotherapy represents the main choice of treatment for such tumors. The efficacy of neoadjuvant and concomitant chemoradiotherapy needs to be further investigated. The proliferative index and angiogenesis show a major role in the natural history of this cancer.
KW - Chemotherapy
KW - Radiotherapy
KW - Sinonasal carcinoma
KW - Surgery
KW - Tumor angiogenesis
UR - http://www.scopus.com/inward/record.url?scp=61349103091&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=61349103091&partnerID=8YFLogxK
U2 - 10.1159/000206140
DO - 10.1159/000206140
M3 - Article
C2 - 19258726
AN - SCOPUS:61349103091
VL - 76
SP - 262
EP - 269
JO - Oncology
JF - Oncology
SN - 0030-2414
IS - 4
ER -