Outcomes and quality of life evaluation following endoscopic endonasal approach for sinonasal malignancies
10.3760/cma.j.issn.1673-0860.2020.01.005
- VernacularTitle: 鼻腔鼻窦恶性肿瘤经鼻内镜手术治疗效果和生活质量评价
- Author:
Na ZHANG
1
;
Qian HUANG
2
;
Shunjiu CUI
2
;
E QIU
3
;
Bentao YANG
4
;
Xiaohong CHEN
2
;
Shurong ZHANG
5
;
Min LI
2
;
Bing ZHOU
2
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Department of Otorhinolaryngology Head and Neck Surgery, Qinhuangdao First Hospital, Hebei Medical University, Qinhuangdao 066000, China
2. Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
3. Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
4. Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
5. Department of Oncology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
Nose neoplasms;
Nasal endoscopic surgery;
Treatment outcome;
Prognosis;
Quality of life
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2020;55(1):21-28
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyse the outcomes and the prognostic factors of patients with sinonasal malignancies following endoscopic endonasal approach, and to compare the pre- and post-operative quality of life.
Methods:A retrospective single-center review of 79 patients who underwent endoscopic endonasal approach for sinonasal malignancies in Beijing Tongren Hospital from October 2004 to March 2017 was performed, including 51 males and 28 females, with a median age of 48 years. Data of demography, imaging (including nasal CT and MRI before operation), histopathology and treatment strategy were collected. Recurrence and distant metastasis were diagnosed according to endoscopic examination, MRI and general check-up after surgery. Pre- and post-operative quality of life scores were obtained by sinonasal outcome test-22, visual analog scale and anterior skull base surgery questionnaire. SPSS 22 software was used for statistical analysis.
Results:The study consisted of 13 pathological types with sinonasal T1-T4 stage tumors, including cervical lymph nodes and/or distant metastasis. All patients underwent endoscopic endonasal approach surgery. After 43 months of median follow-up time, the overall, disease-free, and recurrence-free survival rates at 1, 3, 5 and 10 years was 97.4%, 92.5%, 92.5% and 83.7%; 83.2%, 68.3%, 56.8% and 33.6%; 84.5%, 66.6%, 58.0% and 34.4%, respectively. Postoperative recurrence was an independent risk factor affecting the overall survival rate (HR=8.852, P=0.044), and preoperative recurrence (secondary surgery) was an independent risk factor affecting the disease-free and recurrence-free survival rate (HR value was 2.237 and 2.095 respectively, P value was 0.029 and 0.047 respectively). After surgery, the olfaction and nasal scab got worse, while the nasal obstruction and breathing were improved.
Conclusions:Endoscopic endonasal approach for sinonasal malignancies can achieve satisfactory outcomes, and has obvious advantages in improving the quality of life. Postoperative recurrence and preoperative recurrence are the prognostic factors.
