Long-term survival after surgery for stage III-IV maxillary sinus carcinoma

Objectives: How to optimally treat maxillary sinus carcinoma is subject to debate. This study assessed how clinical features and treatment modalities corresponded with long-term survival. Methods: Sixty-five patients at our institution were diagnosed with maxillary sinus carcinoma from 1982 to 2003. The median follow-up time was 92.9 months. We evaluated the prognostic value of age, gender, symptoms at presentation, histological classification, tumour stage, and treatment modality with regard to overall survival. Results: The five-year survival rate was 52%. Age (p = 0.03), TNM stage (p = 0.04), T classification (p = 0.04), nodal involvement (p = 0.03), and surgery (p = 0.04) were significant prognostic factors for overall survival. There was a significant difference in the overall survival rate and months of survival between patients who underwent surgery and those who had nonsurgical treatment (p = 0.04). In patients with T3 disease, patients who received en bloc surgery had a higher overall survival than patients who received piecemeal surgery (p = 0.045). Multivariate analysis revealed that T classification was the most powerful prognostic factor for overall survival (p = 0.026), followed by nodal involvement (p = 0.036). Surgery was a marginally significant prognostic factor (p = 0.066). Conclusions: Although multivariate analysis showed that T classification and nodal involvement corresponded more with survival than did surgery, we conclude that adequate surgical removal should be an integral component of multimodal treatment.