Postoperative Survival Factors On 69 Patients With Malignant Tumors Of Nasal Cavity And Sinuses

Objectives: To understand the survival status of patients with SNM by surgical treatment,and to provide reference for further improvement of treatment plans,related factors affecting prognosis of patients with SNM in the undergraduate department for nearly 10 years were explored.Methods:Using retrospective methods,69 patients with SNM who were admitted to the Department of Otolaryngology Head and Neck Surgery of the First Affiliated Hospital of Dalian Medical University from January 2008 to December 2018 were included.The postoperative survival of patients was followed up and different clinical characteristics were grouped.The OS rate and MST was described by Kaplan-Meier survival curve,and the differences in prognosis and inter-group differences of different influencing factors were compared by Log-Rank method and Breslow test.Through analysis,OS,MST,RFS and 3,5-year OS rate and RFS rate were obtained,and the mean survival time and 3,5-year OS rate of different clinical characteristics were compared to explore the factors affecting postoperative survival of patients with malignant tumors of the nasal cavity and sinuses,the selected influencing factors are included in the COX regression model for multiple factors regression analysis.Based on the above analysis results,R software was used to visualize the Nomogram model and predict the survival rate,and C-index was calculated and calibration curves were drawn to evaluate the accuracy of the model.Results:All 69 patients,including 40 males and 29 females;elderly(? 60 years old)11cases,middle-aged(45-59 years old)28 cases,youth(? 44 years old)30 cases,aged16-86 years,with an average age of(57.9 ? 13.3)years old;medical expenses,including 16 cases at their own expense,53 cases of insurance;29 cases of open surgery,32 cases of endoscopic sinus surgery,8 cases of combined open surgery under nasal endoscopy or assisted endoscopic surgery Neck dissection was performed,7 cases underwent cervical lymph node dissection at the same time;22 patients underwent radiotherapy alone,29 patients underwent radiotherapy and/or targeted and/or bioimmunotherapy and 18 patients without treatment;preoperative tumor staging,of which 17 patients were in stage I,II 15 cases in stage,20 cases in stage III,17 cases in stage IV;preoperative cervical lymph node metastasis,7 patients with cervical lymph node metastasis,and 62 patients without cervical lymph node metastasis;pathologically,23 patients with squamous cell carcinoma and 19 with adenocarcinoma Cases,13 cases of malignant melanoma,5 cases of olfactory blastoma,4 cases of adenoid cystic carcinoma,2 cases of sarcoma(including 1 case of rhabdomyosarcoma,1 case of leiomyosarcoma),3 cases of rare type(including 1 case of myoepithelial tumor)(1 case of basal cell carcinoma and 1 case of neuroendocrine cancer).To the end of follow-up,The MST and RFS were 76 months,61 months.The OS rates at 3 and 5years were 75.0% and 63.0%,and the RFS at 3 to 5 years,the deposit rates were 70.0%and 55%.Specifically,Comparison of OS rates with different ages,different postoperative treatment plans,different preoperative clinical stages,and with or without cervical lymph node metastasis showed significant differences in early and long-term prognosis(both log-rank method and Breslow test P<0.05).There was no significant difference between gender,surgical method and pathological type and postoperative survival rate(P>0.05).Relatively,there were no significant difference of different genders,surgical methods and pathological types(The P values of Log-Rank and Breslow test were greater than 0.05).The COX regression analysis show that medical expenses and postoperative treatment methods are independent factors affectingprognosis(The P values less that 0.05).The C-index used to verify the Nomogram model is calculated to be 0.826(95CI:0.747-0.904),indicating that the prediction fits the actual OS well.Conclusions:For patients with SNM after surgery,the prognosis of comprehensive treatment is significantly better than that of radiotherapy alone.Economic burden is also one of the important factors affecting prognosis.The method of medical expenses and postoperative treatment are of high value in predicting the prognosis.The older the patient,the higher the preoperative tumor stage,and the worse the prognosis of those with cervical lymph node metastasis.