Prognosis and survival for nasal cavity and paranasal sinus cancer

If you have nasal cavity or paranasal sinus cancer, you may have questions about your prognosis. A prognosis is the doctor's best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.

A prognostic factor is an aspect of the cancer or a characteristic of the person (such as age) that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.

The following are prognostic and predictive factors for nasal cavity and paranasal sinus cancer.

Stage is the most important prognostic factor for cancers of the nasal cavity and paranasal sinuses. The earlier a tumour in the nasal cavity or paranasal sinuses is found, the better the prognosis. Unfortunately, many tumours in the nasal cavity or paranasal sinuses are found at a later stage.

Tumours that have grown into the brain or the outer membrane of the brain have a poor prognosis.

The more lymph nodes that contain cancer and the larger these lymph nodes are, the poorer the prognosis.

Low-grade esthesioneuroblastomas, adenocarcinomas and chondrosarcomas tend to have the best prognosis.

Squamous cell carcinomas (SCCs) tend to have a better prognosis if the cancer started in the ethmoid sinus rather than the nasal cavity or other paranasal sinuses.

Melanoma and sinonasal undifferentiated carcinomas (SNUC) have a poor prognosis.

Younger people tend to have a better prognosis than older people.

Women may have a better prognosis than men.

People who have higher performance status scores may survive longer and cope with the effects of treatment better than those who have lower scores.

A tumour that started in the nasal cavity or paranasal sinuses and has grown into the nasopharynx and base of the skull has a poor prognosis because it is harder to completely remove with surgery.

During surgery, the surgeon removes the tumour along with an area of healthy-looking tissue around it. This tissue is called the surgical margin. If there are cancer cells in the surgical margin, it is called a positive surgical margin. Surgical margins that don't have cancer cells are called negative surgical margins and have a better prognosis than positive surgical margins.

People who don't smoke or drink alcohol tend to have a better prognosis than those who smoke and drink alcohol.