Clinical and biological prognostic factors in 179 cases with sinonasal carcinoma treated in the italian piedmont region

Mario Airoldi, Massimiliano Garzaro, Guido Valente, Carlo Mamo, Antonella Bena, Carlo Giordano, Giancarlo Pecorari, Pietro Gabriele, Anna Maria Gabriele, Fabio Beatrice

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)262-269
Number of pages8
JournalOncology
Volume76
Issue number4
DOIs
Publication statusPublished - Mar 2009

Keywords

  • Chemotherapy
  • Radiotherapy
  • Sinonasal carcinoma
  • Surgery
  • Tumor angiogenesis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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