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Multidisciplinary treatment algorithm for the management of sinonasal cancers with orbital invasion: A retrospective study
Author(s) -
TurriZai Mario,
Lambertoni Alessia,
Margherini Stefano,
Giovannardi Marta,
Ferrari Marco,
Rampinelli Vittorio,
Schreiber Alberto,
Cherubino Mario,
Antogi Paolo,
Locatelli Davide,
Battaglia Paolo,
Castelnuovo Paolo,
Nicolai Piero
Publication year - 2019
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25759
Subject(s) - medicine , orbit (dynamics) , retrospective cohort study , referral , cancer , surgery , family medicine , engineering , aerospace engineering
Abstract Background Sinonasal cancers frequently involve the orbit with resulting controversies on whether to remove or preserve the orbital contents. Methods Retrospective review of patients with primary sinonasal cancer involving the orbit, treated according to a multidisciplinary protocol tailored to tumor histology and extent of orbital invasion in two tertiary care referral centers over a 20‐year period. Results The oncological and functional outcomes of 163 patients were analyzed. The degree of orbital involvement significantly affected both overall ( P < .0001) and disease‐free ( P < .0001) survival. Orbital apex invasion was an independent negative prognostic factor (5‐year overall survival, 14.6% ± 7.5%), with dismal prognosis regardless of the treatment adopted. An appropriate use of induction chemotherapy and endoscopic‐assisted surgery allowed for orbital preservation in 76.6% of cases; 96% of patients treated using an orbit‐sparing approach maintained a functional eye after treatment. Conclusion The multimodal treatment algorithm herein proposed was able to maximize orbital preservation rates with acceptable oncological and functional outcomes.