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Master Thesis

Évaluation multicentrique du traitement chirurgical de l'adénocarcinome nasosinusien de type intestinal

Abstract : Background: the gold-standard treatment for intestinal-type sinonasal adenocarcinomas (ITAC) is surgical resection with or without adjuvant radiotherapy. Our study aims to compare the survival and oncological between the external and endoscopic surgical approach. Material and methods: patients treated surgically for an ITAC were included retrospectively from ten tertiary referral hospitals registered under the REFCOR. Kaplan-Meier curves concerning overall survival, specific survival, recurrence-free survival, local recurrence-free survival and surgical resection margins were analysed then compared in univariate and multivariate analysis using the logrank test and Cox model. The profile of patients with Signet-ring cell was also investigated. Results: a total of 452 patients were included in our study: 195 patients were operated by an external approach (2000-2016) versus 257 patients operated by endoscopic approach (2004-2018). The mean overall follow-up was 59.2 ± 48.7 months (52 months in the endonasal approach group; 68.7 months in the external approach group). Univariate analysis of the surgical approach showed significant results in favour of the endoscopic approach on local recurrence-free survival determined by the ability to achieve better margins.Those results were obtained after standardisation for age, tumour stage, radiotherapy (HR = 2.01 (1.2 - 3.36) , p = 0.0087 ). There was no significant difference between the two groups in overall survival (p = 0.24) or specific survival (p = 0.53). The incidence of complications and length of hospital stay was significantly lower in the endoscopic approach group. Conclusion: using the endoscopic approach allows greater control over local recurrence as tumour margins are better realised compared to the external approach while being less invasive.
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Submitted on : Wednesday, November 18, 2020 - 5:27:41 PM
Last modification on : Thursday, January 21, 2021 - 3:10:31 AM
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  • HAL Id : dumas-03012860, version 1



Alice Waubant. Évaluation multicentrique du traitement chirurgical de l'adénocarcinome nasosinusien de type intestinal. Sciences du Vivant [q-bio]. 2020. ⟨dumas-03012860⟩



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