Treatment outcomes of malignant fibrous histiocytoma of the maxillary sinus

Abstract

Background: Malignant fibrous histiocytoma (MFH) is an uncommon neoplasm of maxillary sinus. This study was designed to investigate the clinical courses and summarize the experience of the treatment outcomes.

Materials and methods: This is a retrospective analysis which included patients with MFH of the maxillary sinus from January 1980 to December 2008 treated in our institute. Survival data were analyzed by means of the Kaplan-Meier method using univariate analysis and Cox regression model using multivariate analysis.

Results: The study included 31 patients. Of which, one patient received radical radiotherapy, and thirty patients received surgical resection. Of these, thirty patients received preoperative radiotherapy, and 11 patients received postoperative radiotherapy. Radical resection with clear surgical margins was obtained in twelve patients (80%) after preoperative radiotherapy, and in eight patients (53.3%) with postoperative radiotherapy (P = 0.221). The 3-year overall survival rate (OS) and recurrence-free survival rate (RFS) were 59.0% and 43.5%, respectively. Patients treated with a radical resection had significantly better survival than patients with a nonradical resection. Three-year OS was 79.8% and 28.1%, 3-year RFS was 61.9% and 18.5%, respectively (P = 0.001 and 0.029, respectively). Local recurrence rate (LRR) was lower in patients resected with clear surgical margins than patients with unclear or uncertain margins, and the 3 years LRR was 33.3% and 72.2%, respectively (P = 0.052).

Conclusions: Surgical resection is the mainstay of treatment for MFH of the maxillary sinus. A radical resection with clear margins is essential for excellent local control and long-term survival.