7th ICHNO Abstract book

7th ICHNO 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ page 41

Purpose or Objective Paranasal sinus cancers are rare neoplasms with a heterogenous histology. Their primary treatment is composed by surgery and can be followed by radiotherapy (RT) or chemoradiotherapy (CRT). The aim of this study was to report the outcomes of patients treated at our institution. Material and Methods Patients with paranasal sinus cancers treated in our institute between July 2008 and December 2014 were identified using a regional cancer database, and their medical records were reviewed. Inclusion criteria were age ≥ 18 years, histologically proven M0 primary cancer of the paranasal sinuses, first treatment with curative intent composed by surgery followed by RT or CRT. We excluded haematological and sarcoma histologies and patients with synchronous second primary malignancies. Estimates of overall survival (OS), progression-free survival (PFS), local control (LC), regional control (RC) and metastasis-free survival (MFS) were obtained using Kaplan-Meier method. Results 55 patients were identified, 8 had hematological or sarcoma histologies, 6 received palliative care upfront and 6 had missing data. 35 patients were analysed, 25 (71%) males and 10 (29%) females with a median age of 58 years (24-81). The most common histology was squamous cell carcinoma 21 (60%), followed by adenoid cystic 6 (17%), other histologies 8 (23%). Patients were re-staged according with the AJCC 8 th edition; T4 was observed in 23 (66%) patients. N+ was present in 5 (14%) patients. All patients underwent upfront surgery, 3 (9%) patients underwent a second surgery as part of the primary treatment, neck node dissection was performed in 7 (20%) patients. R2 surgery was seen in 20%, R1 in 71% and R0 in 9%. RT was performed in all patients, with a median dose of 66 Gy (60-70) to the highest risk volume and a median dose of 2Gy/fr (1,8-2,12). Nodal areas were treated in 11 (31%) patients. CRT was done in 9 (26%) patients. Median time of treatment was 48 days (42-61). Persistence of disease, evaluated 2 months after last treatment, was present in 3 (9%) patients. Local relapse was observed in 10 (29%), 3 (10%) had regional relapse, 4 (13%) developed distant metastasis. Median follow up was 22 months (5- 116) for all patients and 73 months (26-116) for patients alive at the last follow-up. OS at 1, 3 and 5 years was 71,4%, 42,5% and 42,5%. PFS at 1, 3 and 5 years was 58,1%, 41,5% and 41,5%. LC at 1, 3 and 5 years was 79,8%, 64,9% and 54,1%. RC at 1, 3 and 5 years was 88,7% in all three. MFS at 1, 3 and 5 years was 71%, 44,9% and 44,9%. Logrank analysis was statistically significant for OS (graph 1), but not for LC (graph 2). The inversion of T2 and T3 curves are explained by the low number of patients observed (6).

Graph 1

Graph 2

Conclusion In our series, with a majority of T4-staged treated with upfront surgery and adjuvant combined modality, local relapse in the first three years was the most important pattern of failure. Our results were in line with published data. More research is needed to improve these outcomes.