Multicenter study to assess surgical treatments of 452 sinonasal intestinal-type adenocarcinomas: A REFCOR study.
European Journal of Surgical Oncology. 2023-01-01; 49(1): 39-46
DOI: 10.1016/j.ejso.2022.07.021
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1. Eur J Surg Oncol. 2023 Jan;49(1):39-46. doi: 10.1016/j.ejso.2022.07.021. Epub
2022 Aug 13.
Multicenter study to assess surgical treatments of 452 sinonasal intestinal-type
adenocarcinomas: A REFCOR study.
de Gabory L(1), Waubant A(2), Verillaud B(3), Michel J(4), Malard O(5), Rumeau
C(6), Jankowski R(6), Moya-Plana A(7), Vergez S(8), Favier V(9), Mortuaire
G(10), Righini C(11), Patron V(12), Thariat J(13), Dupin C(14), Coelho J(15),
Bénard A(15).
Author information:
(1)Department of Otorhinolaryngology – Head and Neck Surgery, University
Hospital of Bordeaux, Bordeaux, France; Univ. Bordeaux, 33000, France.
Electronic address: .
(2)Department of Otorhinolaryngology – Head and Neck Surgery, University
Hospital of Bordeaux, Bordeaux, France.
(3)Department of Otorhinolaryngology – Head and Neck Surgery, Lariboisière
University Hospital, Paris, France.
(4)Department of Otorhinolaryngology – Head and Neck Surgery, University
Hospital of Marseille, AP-HM Marseille, France.
(5)Department of Otorhinolaryngology – Head and Neck Surgery, University
Hospital of Nantes, Nantes, France.
(6)Departement of Otorhinolaryngology, Université de Lorraine, CHRU Nancy,
Service ORL, F-54000, Nancy, France.
(7)Department of Otorhinolaryngology – Head and Neck Surgery, Gustave Roussy
Cancer Center, Villejuif, France.
(8)Department of Otorhinolaryngology – Head and Neck Surgery, University
Hospital of Toulouse, Toulouse, France.
(9)Department of Otorhinolaryngology – Head and Neck Surgery, University
Hospital of Montpellier, Montpellier, France.
(10)Department of Otorhinolaryngology – Head and Neck Surgery, University
Hospital of Lille, Lille, France.
(11)Department of Otorhinolaryngology – Head and Neck Surgery, University
Hospital of Grenoble, Grenoble, France.
(12)Department of Otorhinolaryngology – Head and Neck Surgery, University
Hospital of Caen, Caen, France.
(13)Centre Francois Baclesse, Cancer Research Center, Department of Oncology, 3,
Avenue du Général Harris, 14000, Caen, France.
(14)Departement of Oncology and Radiotherapy, Hôpital Haut-Lévêque, University
Hospital of Bordeaux, Avenue Magellan, 33600, Pessac, France.
(15)Pôle de Santé Publique, Clinical Epidemiology Unit (USMR), F-33000,
Bordeaux, France.
PURPOSE: 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.
METHODS: 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.
RESULTS: 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