Περίληψη:
Objective/Hypothesis: The treatment of squamous cell carcinoma (SCC) of
the sinonasal tract has evolved from routine exenteration of the orbital
contents to sparing of the orbit when the SCC does not transgress the
periorbita, Nonetheless, the influence of this change in treatment over
the rate of local recurrence or survival has not been clearly
elucidated. The objective was to ascertain whether orbital sparing
surgery for the treatment of SCC of the paranasal sinuses influences the
rate of local recurrence or survival. Study Design: This is a
retrospective study of patients presenting with SCC arising in the
sinonasal tract, treated primarily at the University of Pittsburgh
Medical Center from 1977 to 1990, including meta-analysis of the English
literature regarding SCC of the sinonasal tract. Methods: Review of
medical records regarding demographics, histology, extension of tumor,
pathologic results, type of surgery, adjunctive therapy, and outcome.
Articles for meta-analysis were identified by Medline search and
cross-referencing. Results: Fifty-eight patients with orbital invasion,
including bone and/or soft tissue invasion, were included in the study.
Patients presenting with invasion of the bony orbit without soft tissue
invasion were treated with maxillectomy and/or ethmoidectomy, sparing
the orbital contents. Patients presenting with invasion of the orbital
bones and soft tissues were treated with ethmoidectomy or maxillectomy,
including orbital exenteration, At 3 years’ follow-up, 52% of the
patients whose orbit was exenterated were alive and without evidence of
disease, compared with 59% of the patients whose orbit was spared. This
difference was not statistically significant. Similarly, the rate of
local recurrence was not statistically significant (P > .05), A
mete-analysis of the literature revealed similar results, Conclusions:
Our data suggest that sparing of the soft tissues of the orbit when the
periorbita has not been transgressed by SCC does not downgrade the rate
of cure or local control.
Συγγραφείς:
Carrau, RL
Segas, J
Nuss, DW
Snyderman, CH
Janecka, IP
and Myers, EN
D'Amico, F
Johnson, JT
