Paranasal sinus invasion suggested T4 classification of patients of nasopharyngeal carcinoma: A two-center retrospective investigation.

Abstract

To investigate the prognostic significance of paranasal sinus invasion in nasopharyngeal carcinoma (NPC) patients. Patients with NPC after intensity-modulated radiotherapy from 2010 to 2013 were identified (n = 1225). Clinical features and magnetic resonance images were analyzed. Paranasal sinus invasion was identified in 182/1225 patients (14.9%). Multivariate analysis showed that paranasal sinus invasion was an independent factor for overall survival, progression-free survival, distant metastasis-free survival, and local recurrence-free survival (P < .05 for all). T3 NPC patients with paranasal sinus invasion had a poorer prognosis than those without (P < .05), and there was no significant survival difference compared with T4 patients, regardless of involvement of inner structures (P > .05 for all). Upgrading NPC with paranasal sinus invasion to T4 disease achieved better predictive abilities. Paranasal sinus invasion is an independent prognostic factor for NPC. It may be appropriate to upgrade the T classification.