Impact of tumor volume on prediction of progression free survival in sinonasal cancer
Background: The present study aimed to analyze potential prognostic factors, with emphasis on tumor volume, in determining progression free survival (PFS) for malignancies of the nasal cavity and the paranasal sinuses.
Materials & Methods: Retrospective analysis of 106 patients with primary sinonasal malignancies treated and followed-up between March 2006 and October 2012. Possible predictive parameters for PFS were entered into univariate and multivariate Cox regression analysis. Kaplan-Meier curve analysis included age, sex, baseline tumour volume (based on MR imaging), tumour histology and histological grading (G), T and N stage, TNM and UICC classification. ROC curve analysis concerning the predictive value of tumor volume for recurrence was also conducted.
Results: The main histological subgroup consisted of epithelial tumors (77%). The majority of the patients (68%) showed advanced tumor burden (UICC stadium III-IV). Lymph node involvement was present in 18 cases. The mean tumor volume was 26.6±21.2 cm³. The median PFS for all patients was 24.9 months (range: 2.5-84.5 months). The ROC curve analysis for the tumor volume showed 58.1% sensitivity and 75.4% specificity for predicting recurrence. Tumor volume, TNM and UICC staging, T, N, and G status were significant predictors in the univariate analysis. Positive lymph node status and tumor volume remained significant and independent predictors in the multivariate analysis.
Conclusions: Radiological tumor volume proofed to be a statistically reliable predictor of an unfavorable outcome in terms of short PFS. In the multivariate, analysis, TNM and UICC staging systems did not show significant prognostic value.