What question did this study set out to answer?

The analysis aims to identify new prognostic factors affecting survival in patients with intestinal-type adenocarcinoma of the sinonasal tract.

March 12, 2026Open Access

51MO Prognostic determinants in intestinal-type adenocarcinoma of the sinonasal tract (ITAC): The impact of persistent positive margins after reoperation

GDGiovanni DimaUniversity of Pisa VNV. Di NunnoIstituto delle Scienze Neurologiche di Bologna FVF. VelenosiOspedale Bellaria

Key Points

The analysis aims to identify new prognostic factors affecting survival in patients with intestinal-type adenocarcinoma of the sinonasal tract.
Retrospective assessment of 94 patients with ITAC between 1994 and 2024
Inclusion of cases with histological confirmation and complete clinical data
Survival analysis using the Kaplan-Meier method
Group differences analyzed with the log-rank test
44% of patients experienced recurrence, primarily local
Median time to recurrence was 99 months
Several poor prognosis factors identified including dural invasion and positive margins
Radical surgery at relapse linked to improved survival outcomes

Abstract

Background: Intestinal-Type Adenocarcinomas of the Sinonasal Tract (ITAC) are rare tumors (0.6 patients per 100,000 people) with heterogeneous pathological and clinical features.Prognostic data are extremely limited, and treatment strategies are often derived from small or retrospective studies.The aim of our analysis is to identify new prognostic factors for survival. Methods:In the study, we retrospectively assessed 94 patients with ITAC at our hospital between 1994 and 2024.Only cases with histological confirmation and complete clinical and follow-up data were included.Survival was analyzed using the Kaplan-Meier method, and group differences were assessed with the log-rank test. Results:The median follow-up was 91 months (95% CI: 77-129 months).The cohort consisted mainly of men (n=81, 86%) with a median age of 66 years (range 20-87).The most common histotypes were papillary (n= 33, 35%) and mucinous (n= 26, 28%).Recurrence was observed in 44% of patients, mostly locally (n= 39) with a median time to recurrence of 99 months (95% CI: 80-214).The median overall survival was not reached (95% IC: 171-NA).Univariate analysis revealed several factors associated with poor prognosis: dural invasion (HR 6.8, 95%CI 2.97-15.61,p<0.0001), orbital invasion (HR 3.94, 95CI% 1.5-10.06p=0.002), advanced stage (p<0.0001),grade (p=0.003),mucinous histotype (HR 2.43, 95% CI 1.1-5.5, p=0.03), and positive margins at first surgery (HR 3.3, 95%CI 1.29-8.2,p=0.009), which are consistent with the literature.Radical surgery performed at time of tumor relapse was significantly associated to an improved survival (HR 3.3,. Conclusions:Our data confirm in a large series the main prognostic factors associated with poor prognosis found in the literature.We further reported that radical surgery at time of relapse was associated to an improved survival.Our study suggests that second surgery should be considered when feasible at time of tumor recurrence.

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Cite This Study

Dima et al. (Sun,) studied this question.

synapsesocial.com/papers/69b2584996eeacc4fcec7ca6 https://doi.org/https://doi.org/10.1016/j.esmorc.2026.100257

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