Locally advanced sinonasal adenoid cystic carcinomas: endoscopic endonasal surgery-centered comprehensive treatment provides benefits.

ADENOID cystic carcinoma; OPERATIVE otolaryngology; ENDOSCOPIC surgery; POSTOPERATIVE care; RETROSPECTIVE studies; SURGERY; PATIENTS; CANCER relapse; METASTASIS; SURGICAL complications; TREATMENT effectiveness; CANCER patients; COMPARATIVE studies; DESCRIPTIVE statistics; RADIOTHERAPY; PROGRESSION-free survival; ENDOSCOPY; LONGITUDINAL method; OVERALL survival

Sinonasal adenoid cystic carcinomas (SNACCs) are aggressive tumors that show massive expansion and are challenging to treat when locally advanced. To report our experiences with endoscopic endonasal surgery (EES) – centered comprehensive treatment and discuss the associated outcomes of these patients. A retrospective review of primary locally advanced SNACCs patients was conducted in a single center. EES combined with postoperative radiotherapy (PORT) was used as a comprehensive surgery-centered approach to treat these patients. The study included 44 patients with Stage III/IV tumors. The median follow-up duration was 43 months (4–161 months). Forty-two patients underwent PORT. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 61.2% and 46%, respectively. Local recurrence occurred in 7 patients, and 19 patients had distant metastasis. No significant relationship was found between OS and postoperative local recurrence. The OS of patients with Stage IV or exhibiting distant postoperative metastases was shorter than that of other patients. Locally advanced SNACCs are not a contraindication for EES. EES-centered comprehensive treatment can ensure satisfactory survival rates and reasonable local control. Function-preserving surgery using EES and PORT may represent an alternative strategy when vital structures are involved. [ABSTRACT FROM AUTHOR]

背景：鼻腔腺样囊性癌 (SNACC) 是一种侵袭性肿瘤, 表现为大规模扩散, 当局部发展为晚期时难以治疗。 目的：介绍我们以内窥镜鼻内手术 (EES) 为中心的综合治疗经验, 并讨论这些患者的相关结果。 材料和方法：在一个医疗中心进行的一项对原发性局部晚期 SNACC 患者的回顾性研究。 运将EES联合术后放疗(PORT)用作一种以手术为中心的综合方法来治疗这些患者。 结果：该研究纳入 44 名 III/IV 期肿瘤患者。 中位随访时间为 43 个月(4-161 个月)。 42 名患者接受了 PORT。 5年总生存期(OS)率 和无病生存 (DFS) 率分别为 61.2% 和 46%。 7例出现局部复发, 19例发生远处转移。没有发现在 OS 和术后局部复发之间有显著相关性。 IV 期或术后出现远处转移的患者的OS时间短于其他患者。 结论和意义：局部晚期 SNACC 不是 EES 的禁忌症。以 EES 为中心的综合治疗可确保满意的生存率和合理的局部控制。当累及重要器官时, 使用 EES 和 PORT 的功能保留手术可能是另一种可行方法。 [ABSTRACT FROM AUTHOR]

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