Multicenter study to assess surgical treatments of 452 sinonasal intestinal-type adenocarcinomas: A REFCOR study

The objective was to assess the local oncological outcomes of endoscopic versus external surgical treatment of sinonasal intestinal-type adenocarcinomas (ITAC) and the factors of recurrence. a retrospective non-randomized case-control multicenter study was carried out, including 452 untreated sinona...

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Published in:European journal of surgical oncology 2023-01, Vol.49 (1), p.39-46
Main Authors: de Gabory, Ludovic, Waubant, Alice, Verillaud, Benjamin, Michel, Justin, Malard, Olivier, Rumeau, Cécile, Jankowski, Roger, Moya-Plana, Antoine, Vergez, Sebastien, Favier, Valentin, Mortuaire, Geoffrey, Righini, Christian, Patron, Vincent, Thariat, Juliette, Dupin, Charles, Coelho, Julien, Bénard, Antoine
Format: Article
Language:English
Subjects:
Adenocarcinoma
Adenocarcinoma - pathology
Endoscopic sinus surgery
Endoscopy
Humans
Life Sciences
Nasal cancer
Nose Neoplasms - therapy
Paranasal Sinus Neoplasms - surgery
REFCOR
Retrospective Studies
Santé publique et épidémiologie
Sinus cancer
Wood dust
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Summary:The objective was to assess the local oncological outcomes of endoscopic versus external surgical treatment of sinonasal intestinal-type adenocarcinomas (ITAC) and the factors of recurrence. a retrospective non-randomized case-control multicenter study was carried out, including 452 untreated sinonasal ITACs recruited from 10 tertiary referral centers. The tumors were re-classified according to the UICC 2017 (pT). Survival curves were obtained using the Kaplan-Meier method. Univariate analysis was done with the log-rank test. Multivariate analysis was performed with a Cox model adjusted for age, T stage, and radiotherapy. A binary logistic regression compared surgical complications and performed two supplementary analyses on positive margins. We compared 195 and 257 patients operated by the external and endoscopic approach, respectively. The mean follow-up was 59.2 ± 48.7 months. Post-operative margins were invaded in 30.6 versus 18.9% of patients, respectively (p = 0.007). The overall recurrence rate was 33.8 versus 24.6%, respectively (p = 0.034). There was a significant difference in favor of the endoscopic approach regarding local recurrence-free survival thanks to better surgical margins in univariate and multivariate analysis (Odd Ratio = 2.01 (1.2–3.36) p = 0.0087). The complication rate (Odds Ratio = 3.4 (1.79–6.32) p 
ISSN:0748-7983
1532-2157
DOI:10.1016/j.ejso.2022.07.021