Treatment of cancer of the maxillary sinus. Histological grading of malignancy of squamous cell carcinoma.:Histological Grading of Malignancy of Squamous Cell Carcinoma

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The success of treatment of maxillary sinus carcinoma depends mainly on primary tumor control. Our treatment of maxillary sinus carcinoma is a combination of radiation, chemotherapy and surgery. After 20 Gy irradiation, the tumor is removed as much as possible, followed by intra-arterial infusion of a total dose of 2, 500mg of 5-fluorouracil and 20 Gy irradiation. Then maxillectomy is performed through the oral cavity according to Denker's operation or by extended total maxillectomy.A system for the histological grading of malignancy was applied to 38 squamous cell carcinomas from the maxillary sinus. Six different morphological parameters were evaluated with respect to the tumor cell population and the tumor-host relationship.High-grade malignancy was usually fatal, because of distant metastases. Active treatment with Denker's operation was possible in 17 patients, and 14 of them are now free of tumor, regardless of the malignancy score, with good facial appearance and function. In high malignancy score cases, the tumor has a tendency to invade, and extended total maxillectomy is safer. In low malignancy cases, even in T4 cases, 10 of 22 cases are now free of tumor.
耳鼻咽喉科臨床学会の論文