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Correlation Analysis Of Clinical Features And Prognosis Of 15 Cases Of Rhabdomyosarcoma Of Nasal And Paranasal Sinuses

Posted on:2023-02-18Degree:MasterType:Thesis
Country:ChinaCandidate:Y RenFull Text:PDF
GTID:2544306794961889Subject:Otolaryngology science
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Objective:Clinical and pathological features of bone or soft tissue sarcomas originating in the nasal cavity and paranasal sinuses were retrospectively analyzed.The prognosis and influencing factors of rhabdomyosarcoma were emphatically evaluated in order to achieve early diagnosis,individualized treatment and improve the survival rate of patients.Methods:The medical records and follow-up data of 20 patients admitted to the E.N.T.department from January 2012 to January 2022 who were confirmed as bone or soft tissue sarcoma by pathological tissue biopsies were collected.Analysis was made from gender,age,pathological type,primary lesion location,invasion scope,TNM classification,treatment method,IRS stage and survival situation.The data of patients diagnosed with rhabdomyosarcoma were emphatically analyzed.SPSS 26.0 statistical software was used for descriptive statistical analysis.Kaplan-Meier method was used to evaluate the relationship between clinical data,pathological features,tumor stage and prognosis.Results:1.A total of 20 patients were included in this study,including 13 males and 7 females,with a sex ratio of about 1.8:1.There were 12 adolescents with a median age of 8.5 years old,and 8 adults with a median age of 45.5 years old.Pathological types: 15 cases of rhabdomyosarcoma,2 cases of undifferentiated small round cell sarcoma,1 case of synovial sarcoma,1 case of Ewing’s sarcoma and 1 case of osteosarcoma.The primary site of sarcoma:1 case in nasal cavity,12 cases in maxillary sinus,1 case in ethmoid sinus,6 cases were difficult to distinguish the primary site.2 cases in T1 classification,4 cases in T2classification,6 cases in T3 classification,and 8 cases in T4a classification.6 cases had regional lymph node metastasis,3 cases had distant metastases.2.15 patients were diagnosed as rhabdomyosarcoma,including 10 males and 5females,and the sex ratio was about 2:1.There were 11 adolescents with a median age of 8years old,and 4 adults with a median age of 35 years old.Clinical symptoms: 1 case complained of nasal bleeding,4 cases complained of unilateral nasal obstruction,4 cases complained of maxillary swelling pain,6 cases complained of eyeball protrusion.1 case was diagnosed by histopathologic biopsy,and 14 cases underwent endoscopic nasal surgery(by the same surgeon).12 cases were ERMS,3 cases were ARMS.2 cases in T1 classification,3 cases in T2 classification,4 cases in T3 classification,and 6 cases in T4 a classification.5cases had regional lymph node metastasis,1 case had distant metastases.Treatment methods:1 case received chemotherapy alone.3 patients received operation and postoperative chemotherapy.7 patients received surgery and postoperative CRT.4 patients received preoperative chemotherapy and surgery and postoperative CRT.Follow-up lasted from 3months to 113 months and median follow-up time was 17 months.After treatment,6 cases had no recurrence,4 cases had locoregional recurrence and 5 cases systemic recurrence.8patients survived and seven died.Survival analysis showed that the overall survival rates for1 year and 5 years were calculated as 93.3% and 43.6%.3.Analysis of prognostic factors: pathological type,presence or absence of regional lymph node metastasis,presence or absence of distant metastasis,treatment method,IRS stage were correlated with the prognosis of nasal and paranasal sinus RMS.Conclusion:1.Bone or soft tissue sarcomas originating in the nasal cavity or paranasal sinuses have a high rate of recurrence and mortality.Different pathological types,presence or absence of regional lymph node metastasis,presence or absence of distant metastasis,treatment method,IRS stage were correlated with the prognosis of nasal and paranasal sinus RMS.2.Multiple Disciplinary Team is an effective treatment approach.Operation combined with adjuvant chemoradiotherapy can reduce the recurrence rate and improve the prognosis.3.Improving the clinical and pathological understanding of bone or soft tissue sarcomas,conducting molecular and genomic studies,and finding new therapeutic targets are expected to improve the quality of life and survival rate of patients..
Keywords/Search Tags:nasal cavity and paranasal sinuses, sarcoma, rhabdomyosarcoma, treatment, prognosis
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