Abstract
One hundred and thirty-four cases of cancer of the maxillary sinus observed at the Jikei University School of Medicine in an elevenyear-period were studied clinically.
The results are as follows:
1) Out of 134 tumors in the present series, squamous cell carcinoma was by far the most common malignant tumor (81%) found in the maxillary sinus.
2) The peak incidence appeared in the 5th and 6th decades of life with men being affected more frequently than women in a ratio of 1.73 to 1.
3) Swelling of the cheek was the most common and characteristic symptom in carcinoma of the maxillary sinus. Epistaxis due to carcinoma of the maxillary sinus is frequent but not massive. Patients with epistaxis should always be examined carefully even if the bleeding is not severe.
4) TNM classification of maxillary cancer (JJC) has been found to be a good criterion for predicting the prognosis. The actual 5-year survival rates of our series were 74% for T1+2, 64% for T3 and 26% for T4.
5) The actual 5-year survival rate (Kaplan-Meier method) of the series was 50.1%, and the 5-year corrected survival rate was 54.9%.
6) The arterial infusion of 5-FU through the superficial temporal artery and injection of Vitamine A into the muscle before each irradiation (FAR therapy) which was followed by radical surgery was found to be an effective treatment and produced the best 5-year survival rate of 61.7%.
7) A definite relationship was noticed between the histopathological findings and prognosis, in which well differentiated squamous cell carcinomas showed better prognosis than anaplastic carcinomas.
8) Radical neck dissection is preferable in the presence of neck metastasis after the initial therapy.
9) In Japan, with an increase in the proportion of aged people, the incidence of maxillary cancer is on the increase, so we performed extensive treatments where possible. The 5-year corrected survival rate in 23 patients over 70 years old treated by the combination therapy was 60.2%. In cases without other serious systemic diseases, the combination treatment of chemotherapy, irradiation and subsequent radical maxillectomy should be performed for a better prognosis.
