Chondrosarcoma of the Nose, Paranasal Sinuses, and Skull Base

Objective: To present the outcome of a prospective series of sinonasal chondrosarcoma.

Design: Prospective cohort study.

Material and Method: All patients with sinonasal chondrosarcoma who underwent surgical resection at our institution from 1978 to the present were reviewed. Actuarial disease-free survival analysis was performed using the Kaplan-Meier method.

Results: There were 38 patients, 23 treated with craniofacial resection, 10 by other external approaches, and 5 with endoscopic resection. There were 21 males and 17 female, ages 5 to 76 years (mean, 47.2 years). Follow-up ranged from 12–244 months. Of those treated with craniofacial resection, actuarial survival rates were 94% at 5 years, 56% at 10 years, and 37% at 15 years. For the 10 treated with other external procedures, 5-year and 10-year survival was 60% and 35%, respectively. Of the five patients treated entirely with endoscopic resection, survival is 100% to date, with follow-up ranging from 12–100 months.

Conclusions: Craniofacial resection is considered the “gold standard,” but in selected tumors an endoscopic approach appears to be an appropriate alternative. Local recurrence is the most common cause of death, which may occur after many years due to distant metastases, so lifelong follow-up is needed. Three factors appear to affect prognosis: location and extent of tumor, adequacy of surgery with negative margins, and degree of differentiation of the tumor. Given the importance of local control for prognosis, adjuvant treatments are continuously being sought. One alternative is particle beam radiotherapy, which has shown promising results.