Intestinal type adenocarcinoma of the ethmoid: Outcomes of a treatment regimen based on endoscopic surgery with or without radiotherapy

Background The objective of this study was to assess survival, prognostic factors, and complications in a cohort of patients with intestinal-type adenocarcinoma (ITAC) treated with transnasal endoscopic surgery (ES) ± radiotherapy [RT]. Methods Patients with ITAC who underwent ES ± RT at two tertiary centers were retrospectively reviewed. Overall (OS) and event-free (EFS) survivals were calculated, and statistically significant variables were entered in a multivariate Cox regression model. Complications were also analyzed. Results One-hundred-sixty-nine patients were included. Major complications occurred in 9.5% of patients. Adjuvant RT was delivered in 58.6% of patients. Five-year OS and EFS were 68.9% and 63.6%, respectively. Advanced pT classification, high grade, and positive surgical margins were independently predictive of poor survival. Conclusions ES ± RT is a valid treatment option in most cases of ITAC. When compared with series based on external surgery, our results support a definitive paradigm shift in the management of ITAC.