Background: Intestinal-Type Adenocarcinomas of the Sinonasal Tract (ITAC) are rare tumors (0.6 patients per 100,000 people) with heterogeneous pathological and clinical features.Prognostic data are extremely limited, and treatment strategies are often derived from small or retrospective studies.The aim of our analysis is to identify new prognostic factors for survival. Methods:In the study, we retrospectively assessed 94 patients with ITAC at our hospital between 1994 and 2024.Only cases with histological confirmation and complete clinical and follow-up data were included.Survival was analyzed using the Kaplan-Meier method, and group differences were assessed with the log-rank test. Results:The median follow-up was 91 months (95% CI: 77-129 months).The cohort consisted mainly of men (n=81, 86%) with a median age of 66 years (range 20-87).The most common histotypes were papillary (n= 33, 35%) and mucinous (n= 26, 28%).Recurrence was observed in 44% of patients, mostly locally (n= 39) with a median time to recurrence of 99 months (95% CI: 80-214).The median overall survival was not reached (95% IC: 171-NA).Univariate analysis revealed several factors associated with poor prognosis: dural invasion (HR 6.8, 95%CI 2.97-15.61,p<0.0001), orbital invasion (HR 3.94, 95CI% 1.5-10.06p=0.002), advanced stage (p<0.0001),grade (p=0.003),mucinous histotype (HR 2.43, 95% CI 1.1-5.5, p=0.03), and positive margins at first surgery (HR 3.3, 95%CI 1.29-8.2,p=0.009), which are consistent with the literature.Radical surgery performed at time of tumor relapse was significantly associated to an improved survival (HR 3.3,. Conclusions:Our data confirm in a large series the main prognostic factors associated with poor prognosis found in the literature.We further reported that radical surgery at time of relapse was associated to an improved survival.Our study suggests that second surgery should be considered when feasible at time of tumor recurrence.
Dima et al. (Sun,) studied this question.