A retrospective review of non‐intestinal‐Type adenocarcinoma of nasal cavity and paranasal sinus.

Abstract Background: Adenocarcinomas of the nasal cavity and paranasal sinus, which includes non-intestinal adenocarcinoma of nasal cavity and paranasal sinuses (n-ITAC), are rare and heterogeneous. The diagnosis of n-ITAC is commonly achieved by exclusion, and several entities of considerable biological diversity are included. The literature on n-ITAC is rarely reported. It is reported in the literature that the prognosis of most sinonasal adenocarcinomas still remains poor. We hope that the analysis can provide recommendations for the treatment of n-ITAC.Objective: To analyze the clinical characteristics, outcomes, prognostic factors and the best treatment of n-ITAC.Methods: We located the time on the PACS system of Southern Hospital of Southern Medical University from February 1995 to February 2020. We searched the keyword " n-ITAC " and selected pathology. A total of 16 patients were searched, of which 2 were undiagnosed and 1 lost follow-up. Finally, we analyzed a total of 13 n-ITAC patients.Results: The follow-up time was 34.6 months in average. The 1-year overall survival (OS) rate of G1 tumors was 100%, and the 3-year OS rate was 71.4%. The 1-and 3-year OS rates of G3 tumors were 50% and 16.7%, respectively. It was significantly associated with OS (p=0.03). Pathological grade is an independent prognostic factor. The OS of the surgery group was significantly better than that of the non-surgery group (1-year OS was 90.9% vs 0%, 3-year OS was 54.5% vs 0% P < 0.001). Surgery is an indispensable means of treatment and benefit. Patients with certain risk factors were given radical radiotherapy. The radiation dose for cases without surgery or with positive surgical margin was 66-70Gy/33F, and the dose for cases with negative margin was 60Gy/28F. Conclusions: N-ITAC is a rare disease, and high-grade tumors have a poor prognosis. Surgery is still the main treatment for n-ITAC. Patients with no surgery, high-grade tumors and/or positive surgical margins should be given radical radiotherapy, and preventive radiotherapy in the drainage area of the lymph node at the same time. If the margins are negative, the radiation dose can be appropriately reduced. Whether combined with chemotherapy and targeted therapy needs further study.