Patterns and incidence of neural invasion in patients with cancers of the paranasal sinuses Journal Article
| Authors: | Gil, Z.; Carlson, D. L.; Gupta, A.; Lee, N.; Hoppe, B.; Shah, J. P.; Kraus, D. H. |
| Article Title: | Patterns and incidence of neural invasion in patients with cancers of the paranasal sinuses |
| Abstract: | Objective: To characterize the incidence and pattern of neural invasion (NI) in patients with cancers of the paranasal sinuses and anterior skull base. Design: Retrospective study.Setting: A tertiary referral cancer center.Patients: The study included 208 patients with cancer of the paranasal sinuses. Patients with brain invasion or neurogenic tumors were excluded. Main Outcome Measure: Analysis of clinical and pathologic data on patients with cancer of the paranasal sinuses. Results: Forty-one specimens (20%) had evidence of NI. Sinonasal undifferentiated, adenoid cystic, and squamous cell carcinoma had a high propensity for NI, whereas melanoma and sarcoma rarely invaded nerves. Intraneu-ral invasion was found in 32% of these cases, and 34% invaded more than 1 cm distal to the tumor. Neural invasion was associated with a high rate of positive margins, maxillary origin, and previous surgical treatment (P< .04) butnotwith stage, orbital invasion, or dural invasion. Patients with NI were more likely to undergo adjuvant radiotherapy (P = .003), which significantly improved survival in patients with minor salivary gland carcinomas (P= .04). Multivariate analysis showed that pathologic evidence of NI was not an independent predictor of outcome. Conclusions: Paranasal carcinomas have high propensity for NI, whereas melanoma and sarcoma rarely invade nerves. Patterns of NI include both perineural and intra-neural invasion. Neural invasion is associated with positive margins, maxillary origin, and previous surgery. © 2009 American Medical Association. All rights reserved. |
| Keywords: | adolescent; adult; cancer survival; child; human tissue; preschool child; aged; aged, 80 and over; middle aged; retrospective studies; major clinical study; squamous cell carcinoma; carcinoma, squamous cell; pathophysiology; cancer patient; outcome assessment; cancer incidence; adenocarcinoma; disease association; melanoma; tumor volume; retrospective study; cancer invasion; cancer center; carcinoma; predictor variable; neoplasm invasiveness; tertiary health care; skull base; peripheral nerves; skull base neoplasms; cancer classification; adenoid cystic carcinoma; nerve cell; maxilla; paranasal sinus cancer; salivary gland carcinoma; carcinoma, adenoid cystic; paranasal sinus neoplasms |
| Journal Title: | Archives of Otolaryngology - Head & Neck Surgery |
| Volume: | 135 |
| Issue: | 2 |
| ISSN: | 0886-4470 |
| Publisher: | American Medical Association |
| Date Published: | 2009-02-01 |
| Start Page: | 173 |
| End Page: | 179 |
| Language: | English |
| DOI: | 10.1001/archoto.2008.525 |
| PUBMED: | 19221246 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 3" - "Export Date: 30 November 2010" - "CODEN: AONSE" - "Source: Scopus" |
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