Sino-nasal neuro-endocrine carcinoma

Abstract

Conclusion: Patients with sino-nasal neuro-endocrine carcinoma should be managed by multi-modality treatment that includes surgery and postoperative chemo-radiotherapy as described in our treatment plan. Even though current combined therapy results in good disease control and survival rate, long-term follow-up is necessary. Objective: Neuro-endocrine carcinoma is an aggressive and rare malignant tumor of the sino-nasal tract, and its management remains divergent. The aim of this paper is to present our experience in the management of this kind of aggressive tumor and compare different treatment plans in order to draw up an effective strategy. Various treatment strategies were reviewed and assessed. Methods: Seven patients with biopsy-proven primary sino-nasal neuro-endocrine carcinoma from July 2004 to December 2006 were evaluated. The staging system was based on the American Joint Committee on Cancer Staging Manual of 2002. All of the patients underwent endoscopic or open surgery with curative intent. Six patients received postoperative chemo-radiotherapy. Results: The median follow-up after surgery was 43.5 months (range 26.9–57.7 months). One patient was T2N0M0, one was T3N0M0, four were T4aN0M0, and one was T4bN0M0. After endoscopic or open surgery and postoperative chemo-radiotherapy, six patients were alive with no evidence of recurrence. One patient had persistent tumor without clinical and imaging changes for 36.9 months. After the whole treatment course, one patient had sino-cutaneous fistula and underwent flap reconstruction. None had regional failure or distant metastasis during follow-up.