neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2022-24-4-22-31neurosurgery-1284Research ArticleОРИГИНАЛЬНАЯ РАБОТАORIGINAL REPORTХирургическое лечение аденокистозных карцином синоназальной локализацииSurgical treatment of adenoid cystic carcinomas of sinonasal localizationhttps://orcid.org/0000-0002-8056-3190СпиринД. С.SpirinrinD. S.

Дмитрий Сергеевич Спирин

125047 Москва, ул. 4-я Тверская-Ямская, 16

Dmitriy Sergeevich Spirin

16 4th Tverskaya-Yamskaya St., Moscow 125047

DSpirin@nsi.ruhttps://orcid.org/0000-0002-0909-6278РешетовИ. В.ReshetovI. V.

119991 Москва, ул. Трубецкая, 8, стр. 2

Bld. 2, 8 Trubetskaya Str., Moscow 119991

https://orcid.org/0000-0001-6881-7082ЧерекаевВ. А.CherekaevV. A.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-9789-3452ЧерновИ. В.ChernovI. V.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-7651-4214КобяковГ. Л.KobyakovG. L.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-0976-4547ГолановА. В.GolanovA. V.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0003-3868-7664ТлисоваМ. Н.TlisovaM. N.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-0719-5168ДонскойА. Д.DonskoyA. D.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-4904-0324ВетловаЕ. Р.VetlovaE. R.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0003-3827-8676ИвановВ. В.IvanovV. V.

125993 Москва, ул. Баррикадная, 2/1, стр. 1

2/1 Bld. 1 Barrikadnaya St., Moscow 125993

https://orcid.org/0000-0001-9333-9473КалининП. Л.KalininP. L.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

ФГАУ «Национальный медицинский исследовательский центр нейрохирургии им. акад. Н. Н. Бурденко» Минздрава РоссииРоссияN. N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of RussiaRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет им. И. М. Сеченова Минздрава РоссииРоссияI. M. Sechenov First Moscow State Medical University (Sechenov University)Russian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian FederationRussian Federation2022261220222442231Copyright © Спирин Д.С., Решетов И.В., Черекаев В.А., Чернов И.В., Кобяков Г.Л., Голанов А.В., Тлисова М.Н., Донской А.Д., Ветлова Е.Р., Иванов В.В., Калинин П.Л., 20222022Спирин Д.С., Решетов И.В., Черекаев В.А., Чернов И.В., Кобяков Г.Л., Голанов А.В., Тлисова М.Н., Донской А.Д., Ветлова Е.Р., Иванов В.В., Калинин П.Л.Spirinrin D.S., Reshetov I.V., Cherekaev V.A., Chernov I.V., Kobyakov G.L., Golanov A.V., Tlisova M.N., Donskoy A.D., Vetlova E.R., Ivanov V.V., Kalinin P.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1284Введение

Введение. Опухоли синоназальной области – большая группа как доброкачественных, так и злокачественных образований, поражающих полость носа, околоносовые пазухи, структуры передней и средней черепных ямок основания черепа.

Цель работы – оценка результатов хирургического лечения пациентов с аденокистозными карциномами синоназальной локализации, пролеченных в период с 2007 по 2021 г.

Материалы и методы

Материалы и методы. Настоящее исследование – ретроспективный анализ результатов хирургического лечения пациентов с аденокистозным раком основания черепа, оперированных в ФГАУ «НМИЦ нейрохирургии им. акад. Н.Н. Бурденко» Минздрава России в период с 2007 по 2021 г.

Результаты

Результаты. Радикальность удаления опухоли оценивалась на основании данных магнитно‑резонансной томографии, выполненной не ранее 3 мес после операции. Тотального (95–100 %) удаления опухоли удалось достичь у 8 (25 %), субтотального (80–95 %) – у 15 (46,9 %), частичного (50–80 %) – у 5 (15,6 %) пациентов; расширенная биопсия выполнена в 4 (12,5 %) случаях. При этом тотального и субтотального удаления чаще удавалось добиться при открытой хирургии (выбор был связан с топографо‑анатомическими особенностями расположения опухолей).

Обсуждение

Обсуждение. В представленной работе приведен анализ результатов лечения 32 пациентов с аденокистозным раком синоназальной локализации.

Основной метод лечения – комплексный подход: радикальная хирургическая резекция опухоли совместно с адъювантной лучевой терапией. Хирургическое лечение направлено на максимально возможную резекцию патологических тканей для предотвращения рецидива заболевания.

Один из самых распространенных доступов – трансфациальный с бифронтальной краниотомией или без нее, включающий в себя краниофациальную резекцию.

Заключение

Заключение. Аденокистозная карцинома – агрессивная злокачественная опухоль, требующая комплексного подхода к лечению. Важные факторы, положительно влияющие на результаты лечения: химиолучевое лечение; возраст пациентов; исходная стадия заболевания, при которой начато лечение; усиление диспансерного наблюдения; осведомленность населения о возможности развития подобных заболеваний, необходимости регулярной диспансеризации для своевременного обращения к врачу.

Background

Background. Tumors of the sinonasal region represent a large group of both benign and malignant formations affecting the nasal cavity, paranasal sinuses, structures of the anterior and middle cranial pits of the base of the skull.

Aim

Aim. Evaluation of the results of surgical treatment of patients with adenoid cystic carcinomas of sinonasal localization treated in the period from 2007 to 2021.

Material and methods

Material and methods. The present study is a retrospective analysis of the results of surgical treatment of patients with adenoid cystic cancer of the base of the skull operated at the N.N. Burdenko National Medical Research Center of Neurosurgery in the period from 2007 to 2021.

Results

Results. The radicality of tumor removal was assessed based on an MRI analysis performed no earlier than 3 months after surgery. Total (95–100 %) tumor removal was achieved in 8 (25 %), subtotal (80–95 %) in 15 (46.9 %), partial (50–80 %) in 5 (15.6 %) patients; extended biopsy was performed in 4 (12.5 %) cases. At the same time, total and subtotal removal was more often achieved with open surgery, which was due to the topographic and anatomical features of the location of tumors.

Discussion

Discussion. In this paper, we present an analysis of the results of treatment of 32 patients with adenocystic cancer of sinonasal localization.

The main method of treatment is an integrated approach – radical surgical resection of the tumor together with adjuvant radiation therapy. Surgical treatment is aimed at the maximum possible resection of pathological tissues to prevent recurrence of the disease.

One of the most common approaches is transfacial with or without bifrontal craniotomy, which includes craniofacial resection.

Conclusion

Conclusion. Adenoid cystic carcinoma is an aggressive malignant tumor that requires a comprehensive approach to treatment. Important factors that positively affect the results of treatment are the conduct of chemoradiation treatment and the age of patients, as well as the initial stage of the disease at which treatment was initiated, which necessitates strengthening dispensary monitoring and raising awareness of the population about the possibility of developing such diseases for timely access to a doctor.

аденокистозная карциномахирургия основания черепакраниофациальная нейрохирургияэндоназальная эндоскопическая хирургияadenoid cystic carcinomaskull base surgerycraniofacial neurosurgeryendonasal endoscopic surgeryReferencesThompson L.D.R., Franchi A. New tumor entities in the 4th edition of the World Health Organization classification of head and neck tumors: Nasal cavity, paranasal sinuses and skull base. Virchows Arch 2018;472(3):315–30. DOI: 10.1007/s00428-017-2116-0Thompson L.D.R., Franchi A. New tumor entities in the 4th edition of the World Health Organization classification of head and neck tumors: Nasal cavity, paranasal sinuses and skull base. Virchows Arch 2018;472(3):315–30. DOI: 10.1007/s00428-017-2116-0Lund V.J., Stammberger H., Nicolai P. et al. European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinol Suppl 2010;22:1–143.Lund V.J., Stammberger H., Nicolai P. et al. European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinol Suppl 2010;22:1–143.Bradley P.J. Adenoid cystic carcinoma evaluation and management: progress with optimism! Curr Opin Otolaryngol Head Neck Surg 2017;25(2):147–53. DOI: 10.1097/MOO.0000000000000347Bradley P.J. Adenoid cystic carcinoma evaluation and management: progress with optimism! Curr Opin Otolaryngol Head Neck Surg 2017;25(2):147–53. DOI: 10.1097/MOO.0000000000000347Turner J.H., Reh D.D. Incidence and survival in patients with sinonasal cancer: a historical analysis of population-based data. Head Neck 2012;34(6):877–85. DOI: 10.1002/hed.21830Turner J.H., Reh D.D. Incidence and survival in patients with sinonasal cancer: a historical analysis of population-based data. Head Neck 2012;34(6):877–85. DOI: 10.1002/hed.21830Bjorndal K., Krogdahl A., Therkildsen M.H. et al. Salivary gland carcinoma in Denmark 1990-2005: a national study of incidence, site and histology. Results of the Danish Head and Neck Cancer Group (DAHANCA). Oral Oncol 2011;47(7):677–82. DOI: 10.1016/j.oraloncology.2011.04.020Bjorndal K., Krogdahl A., Therkildsen M.H. et al. Salivary gland carcinoma in Denmark 1990-2005: a national study of incidence, site and histology. Results of the Danish Head and Neck Cancer Group (DAHANCA). Oral Oncol 2011;47(7):677–82. DOI: 10.1016/j.oraloncology.2011.04.020Warren T.A., Nagle C.M., Bowman J., Panizza B.J. The natural history and treatment outcomes of perineural spread of malignancy within the head and neck. J Neurol Surg Part B Skull Base 2016;77(2):107–12. DOI: 10.1055/s-0036-1579777Warren T.A., Nagle C.M., Bowman J., Panizza B.J. The natural history and treatment outcomes of perineural spread of malignancy within the head and neck. J Neurol Surg Part B Skull Base 2016;77(2):107–12. DOI: 10.1055/s-0036-1579777Li N., Xu L., Zhao H. et al. A comparison of the demographics, clinical features, and survival of patients with adenoid cystic carcinoma of major and minor salivary glands versus less common sites within the Surveillance, Epidemiology, and End Results registry. Cancer 2012;118(16):3945–53. DOI: 10.1002/cncr.26740Li N., Xu L., Zhao H. et al. A comparison of the demographics, clinical features, and survival of patients with adenoid cystic carcinoma of major and minor salivary glands versus less common sites within the Surveillance, Epidemiology, and End Results registry. Cancer 2012;118(16):3945–53. DOI: 10.1002/cncr.26740Boukheris H., Curtis R.E., Land C.E., Dores G.M. Incidence of carcinoma of the major salivary glands according to the WHO classification, 1992 to 2006: a population-based study in the United States. Cancer Epidemiol Biomarkers Prev 2009;18(11):2899–906. DOI: 10.1158/1055-9965.EPI-09-0638Boukheris H., Curtis R.E., Land C.E., Dores G.M. Incidence of carcinoma of the major salivary glands according to the WHO classification, 1992 to 2006: a population-based study in the United States. Cancer Epidemiol Biomarkers Prev 2009;18(11):2899–906. DOI: 10.1158/1055-9965.EPI-09-0638Belulescu I.C., Margaritescu C., Dumitrescu C.I. et al. Adenoid cystic carcinoma of salivary gland: a ten-year single institute experience. Curr Health Sci J 2020;46(1):56–65. DOI: 10.12865/CHSJ.46.01.08Belulescu I.C., Margaritescu C., Dumitrescu C.I. et al. Adenoid cystic carcinoma of salivary gland: a ten-year single institute experience. Curr Health Sci J 2020;46(1):56–65. DOI: 10.12865/CHSJ.46.01.08Martinez-Rodriguez N., Leco-Berrocal I., Rubio-Alonso L. et al. Epidemiology and treatment of adenoid cystic carcinoma of the minor salivary glands: a meta-analytic study. Med Oral Patol Oral Cir Bucal 2011;16(7):e884–9. DOI: 10.4317/medoral.17200Martinez-Rodriguez N., Leco-Berrocal I., Rubio-Alonso L. et al. Epidemiology and treatment of adenoid cystic carcinoma of the minor salivary glands: a meta-analytic study. Med Oral Patol Oral Cir Bucal 2011;16(7):e884–9. DOI: 10.4317/medoral.17200Guazzo E., Panizza B. Management of advanced adenoid cystic carcinoma infiltrating the skull base: a contemporary review. J Neurooncol 2020;150(3):419–27. DOI: 10.1007/s11060-019-03366-xGuazzo E., Panizza B. Management of advanced adenoid cystic carcinoma infiltrating the skull base: a contemporary review. J Neurooncol 2020;150(3):419–27. DOI: 10.1007/s11060-019-03366-xCoca-Pelaz A., Rodrigo J.P., Bradley P.J. et al. Adenoid cystic carcinoma of the head and neck – an update. Oral Oncol 2015;51(7):652–61. DOI: 10.1016/j.oraloncology.2015.04.005Coca-Pelaz A., Rodrigo J.P., Bradley P.J. et al. Adenoid cystic carcinoma of the head and neck – an update. Oral Oncol 2015;51(7):652–61. DOI: 10.1016/j.oraloncology.2015.04.005International Head and Neck Scientific Group. Cervical lymph node metastasis in adenoid cystic carcinoma of the major salivary glands. J Laryngol Otol 2017;131(2):96–105. DOI: 10.1017/S0022215116009749International Head and Neck Scientific Group. Cervical lymph node metastasis in adenoid cystic carcinoma of the major salivary glands. J Laryngol Otol 2017;131(2):96–105. DOI: 10.1017/S0022215116009749Gomez D.R., Hoppe B.S., Wolden S.L. et al. Outcomes and prognostic variables in adenoid cystic carcinoma of the head and neck: a recent experience. Int J Radiat Oncol Biol Phys 2008;70(5):1365–72. DOI: 10.1016/j.ijrobp.2007.08.008Gomez D.R., Hoppe B.S., Wolden S.L. et al. Outcomes and prognostic variables in adenoid cystic carcinoma of the head and neck: a recent experience. Int J Radiat Oncol Biol Phys 2008;70(5):1365–72. DOI: 10.1016/j.ijrobp.2007.08.008Hanna E., DeMonte F., Ibrahim S. Endoscopic resection of sinonasal cancers with and without craniotomy. Arch Otolaryngol Head Neck Surg 2009;135(12):1219–24. DOI: 10.1001/archoto.2009.173Hanna E., DeMonte F., Ibrahim S. Endoscopic resection of sinonasal cancers with and without craniotomy. Arch Otolaryngol Head Neck Surg 2009;135(12):1219–24. DOI: 10.1001/archoto.2009.173Кит О.И., Решетов И.В., Енгибарян М.А. Инновационный подход к хирургическому лечению местнораспространенного рака околоносовых пазух и полости носа. Вестник Российской академии медицинских наук 2021;76(3):317–23. DOI: 10.15690/vramn1393Kit O.I., Reshetov I.V., Engibaryan M.A. Innovative approach to surgical treatment for locally advanced cancer of paranasal sinus and nasal cavity. Annals of the Russian academy of medical sciences 2021;76(3):317–23. (In Russ.). DOI: 10.15690/vramn1393Мудунов А.М. Опухоли основания черепа. Клиника, диагностика, лечение. Автореф. дис. ... д-ра мед. наук. М., 2010. 42 с.Mudunov A.M. Tumors of the skull base. Clinic, diagnosis, treatment. Abstract of the dis. ... of doctor of med. sciences. Moscow, 2010. 42 p. (In Russ.).Ramakrishna R., Raza S.M., Kupferman M. et al. Adenoid cystic carcinoma of the skull base: results with an aggressive multidisciplinary approach. J Neurosurg 2016;124(1):115–21. DOI: 10.3171/2015.1.JNS142462Ramakrishna R., Raza S.M., Kupferman M. et al. Adenoid cystic carcinoma of the skull base: results with an aggressive multidisciplinary approach. J Neurosurg 2016;124(1):115–21. DOI: 10.3171/2015.1.JNS142462Болотина Л.В., Владимирова Л.Ю., Деньгина Н.В. и др. Практические рекомендации по лечению злокачественных опухолей головы и шеи. Злокачественные опухоли 2021;11(3s2 Suppl 1):91–106. DOI: 10.18027/2224-5057-2021-11-3s2-06Bolotina L.V., Vladimirova L.Yu., Dengina N.V. et al. Practical recommendations for the treatment of malignant tumors of the head and neck. Malignant tumours 2021;11(3s2 Suppl 1): 91–106. (In Russ.). DOI: 10.18027/2224-5057-2021-11-3s2-06Higgins T.S., Thorp B., Rawlings B.A., Han J.K. Outcome results of endoscopic vs craniofacial resection of sinonasal malignancies: a systematic review and pooled-data analysis. Int Forum Allergy Rhinol 2011;1(4):255–61. DOI: 10.1002/alr.20051Higgins T.S., Thorp B., Rawlings B.A., Han J.K. Outcome results of endoscopic vs craniofacial resection of sinonasal malignancies: a systematic review and pooled-data analysis. Int Forum Allergy Rhinol 2011;1(4):255–61. DOI: 10.1002/alr.20051Roxbury C.R., Ishii M., Richmon J.D. et al. Endonasal endoscopic surgery in the management of sinonasal and anterior skull base malignancies. Head Neck Pathol 2016;10(1):13–22. DOI: 10.1007/s12105-016-0687-8Roxbury C.R., Ishii M., Richmon J.D. et al. Endonasal endoscopic surgery in the management of sinonasal and anterior skull base malignancies. Head Neck Pathol 2016;10(1):13–22. DOI: 10.1007/s12105-016-0687-8Lee J.I., Kim Y.Z., Lee E.H., Kim K.H. Skull base invasion of adenoid cystic carcinoma of the lacrimal gland: a case report. J Korean Neurosurg Soc 2008;44(4):273–6. DOI: 10.3340/jkns.2008.44.4.273Lee J.I., Kim Y.Z., Lee E.H., Kim K.H. Skull base invasion of adenoid cystic carcinoma of the lacrimal gland: a case report. J Korean Neurosurg Soc 2008;44(4):273–6. DOI: 10.3340/jkns.2008.44.4.273Guazzo E., Bowman J., Porceddu S. et al. Advanced adenoid cystic carcinoma of the skull base – the role of surgery. Oral Oncol 2019;99:104466. DOI: 10.1016/j.oraloncology.2019.104466Guazzo E., Bowman J., Porceddu S. et al. Advanced adenoid cystic carcinoma of the skull base – the role of surgery. Oral Oncol 2019;99:104466. DOI: 10.1016/j.oraloncology.2019.104466Issing P.R., Hemmanouil I., Stover T. et al. Adenoid cystic carcinoma of the skull base. Skull Base Surg 1999;9(4):271–5. DOI: 10.1055/s-2008-1058137Issing P.R., Hemmanouil I., Stover T. et al. Adenoid cystic carcinoma of the skull base. Skull Base Surg 1999;9(4):271–5. DOI: 10.1055/s-2008-1058137Terhaard C.H.J., Lubsen H., Rasch C.R.N. et al. The role of radiotherapy in the treatment of malignant salivary gland tumors. Int J Radiat Oncol Biol Phys 2005;61(1):103–11. DOI: 10.1016/j.ijrobp.2004.03.018Terhaard C.H.J., Lubsen H., Rasch C.R.N. et al. The role of radiotherapy in the treatment of malignant salivary gland tumors. Int J Radiat Oncol Biol Phys 2005;61(1):103–11. DOI: 10.1016/j.ijrobp.2004.03.018Chen A.M., Bucci M.K., Weinberg V. et al. Adenoid cystic carcinoma of the head and neck treated by surgery with or without postoperative radiation therapy: prognostic features of recurrence. Int J Radiat Oncol Biol Phys 2006;66(1):152–9. DOI: 10.1016/j.ijrobp.2006.04.014Chen A.M., Bucci M.K., Weinberg V. et al. Adenoid cystic carcinoma of the head and neck treated by surgery with or without postoperative radiation therapy: prognostic features of recurrence. Int J Radiat Oncol Biol Phys 2006;66(1):152–9. DOI: 10.1016/j.ijrobp.2006.04.014Lorini L., Ardighieri L., Bozzola A. et al. Prognosis and management of recurrent and/or metastatic head and neck adenoid cystic carcinoma. Oral Oncol 2021;115:105213. DOI: 10.1016/j.oraloncology.2021.105213Lorini L., Ardighieri L., Bozzola A. et al. Prognosis and management of recurrent and/or metastatic head and neck adenoid cystic carcinoma. Oral Oncol 2021;115:105213. DOI: 10.1016/j.oraloncology.2021.105213

The authors declare that there are no conflicts of interest present.