SARCOMAS OF THE NASAL CAVITY AND PARANASAL SINUSES

Sarcomas of the nose and paranasal sinuses are rare malignancies. Key issues remain unresolved in the management of these tumors, particular ly with regard to the role of radiotherapy. To help clarify these issu es, 48 consecutive cases of nasal and paranasal sinus sarcomas treated at the University of California, Los Angeles, between 1958 and 1988 w ere retrospectively reviewed. Six of 16 patients managed initially wit h surgery alone were cured. All had negative surgical margins and 5 of the 6 had low-grade tumors. Of 5 patients with high-grade lesions tre ated with surgery only, 1 was rendered free of disease. Twelve patient s with positive surgical margins were treated with adjuvant radiothera py; 5 were cured with this approach. Grade and surgical margin status were found to be significantly related to outcome for sinonasal sarcom a. There were 14 patients with rhabdomyosarcoma; 3 were cured with mod em combined-modality therapy. Patients with positive surgical margins should be treated with adjuvant radiotherapy. Surgical therapy is effe ctive for low-grade lesions that are completely excised.