Malignant neoplasms of the nasal cavities and paranasal sinuses: (a retrospective study).

This study presents a retrospective look at 115 patients evaluated here from 1957 to 1974. In this series, 57 percent were males and 43 percent females, 84 percent were Caucasian and 16 percent Negro. Lesions confined to or originating in the antrum made up 67 percent while nonantral lesions were 33 percent. Mean age at diagnosis was 59.1 years. Smoking and drinking history did not appear to be contributory. Antral lesions were retrospectively staged according to Sisson's TNM classification. Sixteen tumor types were involved, with the most common being epidermoid. Diagnosis was most often made by intranasal or Caldwell-Luc biopsy. Most frequent symptoms, as well as earliest symptoms, were nasal obstruction, localized pain, and epistaxis. Average duration of symptoms was 6.4 months. Therapy was generally in the form of radiotherapy alone, preoperative radiotherapy and surgery, surgery and postoperative radiotherapy, or surgery alone. Local recurrences occurred in 44 percent of antral lesions and 50 percent of non-antral lesions. Regional (cervical) nodal metastases developed in 25 percent of antral lesions and 11 percent of non-antral lesions. Distant metastases developed in 30 percent of antral cases and 35 percent of non-antral cases. Five-year survival was 32 percent (35 percent determinate) for the total group. The more advanced the staging of the antral lesions, the worse the prognosis. Best survival figures were in the areas of preoperative radiotherapy and surgery at 38 percent (43 percent) and surgery alone at 56 percent (59 percent).