Comparison of 5-year survival rates and prognostic factors between adenoid cystic carcinoma and squamous cell carcinoma of the maxillary sinus: a SEER database analysis.

BACKGROUND

Maxillary sinus carcinoma is a rare and heterogeneous sinonasal malignancy, with prognosis varying substantially by histological subtype. Maxillary sinus adenoid cystic carcinoma (MSACC) and maxillary sinus squamous cell carcinoma (MSSCC) differ in biological behavior and clinical outcomes, but direct comparisons between them remain limited. This study used the Surveillance, Epidemiology, and End Results (SEER) database to compare the 5-year survival differences between MSACC and MSSCC, and to explore the prognostic factors of these two tumors.

METHODS

Patients with MSACC and MSSCC diagnosed between 2004 and 2019 were identified from the SEER database. Overall survival (OS) and cancer-specific survival (CSS) were set as primary outcomes. Kaplan-Meier curves and log-rank tests were used for survival comparison. Cox proportional hazards regression was applied to determine independent prognostic factors. A prognostic model was constructed based on these factors.

RESULTS

Kaplan-Meier analysis showed significantly better survival in MSACC compared with MSSCC (log-rank P<0.001). The 3- and 5-year OS rates were 73.2% and 58.5% for MSACC versus 39.6% and 32.7% for MSSCC, while the 3- and 5-year CSS rates were 78.0% and 64.6% versus 51.2% and 46.3%, respectively. Multivariate Cox regression identified age >60 years, advanced T stage, and absence of surgery as independent adverse prognostic factors, while radiotherapy was associated with improved survival. The prognostic model incorporating these factors demonstrated good discrimination and calibration.

CONCLUSIONS

Patients with MSACC have significantly better OS and CSS than those with MSSCC. Age, T stage, surgery, and radiotherapy are important prognostic factors. The prediction model based on these variables may serve as a useful tool for prognostic evaluation and risk stratification.