Treatment of primary sphenoid sinus malignancies: an analysis of 16 patients

Objective: To analyze the treatment outcomes of patients with primary sphenoid sinus malignancies. Methods: Sixteen patients with primary sphenoid sinus malignancies admitted to our hospital from 2000 to 2013 were analyzed retrospectively. No patients were newly diagnosed with cervical lymph node metastasis. One patient had stage disease, while fifteen had stage disease. Eleven patients received surgery followed by radiotherapy, one surgery alone, three radiotherapy alone, and one chemotherapy alone. All surgeries were cytoreductive. The median dose of radiotherapy was 69.96 Gy (56.00-80.56 Gy). Results: The 3-year local control (LC), distant metastasis-free survival (DMFS), disease-free survival (DFS), and disease-specific survival (DSS) rates were 67%, 69%, 44%, and 58%, respectively, in all patients, and 67%, 55%, 30%, and 41%, respectively, in patients treated with cytoreductive surgery followed by radiotherapy. All orbital contents and skull base were preserved. In all patients, the local recurrence, distant metastasis, and lymph node recurrence rates were 25%, 37%, and 6%, respectively. There were no independent predictors for the LC and DSS rates based on the prognostic analysis. Conclusions: With the orbital contents and skull base preserved, the cytoreductive surgery followed by radiotherapy yields satisfactory outcomes and a low lymph node recurrence rate in the treatment of sphenoid sinus malignancies. The prophylactic irradiation of cervical lymph nodes is not recommended in clinical practice. (authors)