Issue N# 1 - 2001
RHINOLOGY
Adenocarcinoma of the ethmoid : a review of 76 cases.
Authors : D. Stoll, J. P. Bébéar, Y. Truilhé, V. Darrouzet, N. David (Bordeaux)
Ref. : Rev Laryngol Otol Rhinol. 2001;122,1:21-29.
Article published in french 
Downloadable PDF document french
Summary :
From the retrospective study of 76 adenocarcinomas of the ethmoid sinuses, results were expressed in two terms : the morbidity related to surgery and the oncologic outcome. This case study extends between 1975 and 2000. It includs 71 men and 5 women, with an average of 61 years. 81 % of them works in wood dust, with a mean duration of exposure of 26 years. The diagnosis of adenocarcinoma is realized in the three months after the first signs, essentialy rhinologicals, next neurologicals and ophtalmologicals. The majority of tumors were classified as T3N0M0, i.e. 57.89 %. The treatment of this tumors is surgical : 34.2 % surgical only and 59.2 % with radiotherapy. The transfacial approach (paralateronasal and degloving) and the combined surgery are respectively performed in 36 patients and 35 patients. 23,2 % patients had a local recurrence, and 10 % developped cervical nodes and systemic metastasis. Survival rate based on the Kaplan-Meier actuarial method is 82 % at 3 years, 80 % at 5 years, 72 % at 10 years. The prognosis of ethmoidal cancer is strictly correlated to local control. Local recurrence is stastitically more likely in patients with involvement of the dura, brain and sphenoid sinus. With the analysis of the carcinologics results, we discuss the therapeutics indications of the adenocarcinomas and a new classification. Taking in account the involvement of the dura, sphenoid and orbit. We did not find any statistical differences between T3 patients treated by combined approach (n=13) or by transfacial approach (n=15).
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