Oncologic Outcomes of Treating Patients with Locally Advanced Sinonasal Tumors Using the “Dismasking” Approach

Objective. To evaluate the oncologic outcomes of surgical treatment for locally advanced tumors of the midface, with specific analysis of resection margin status (R-status), local control, overall survival, and disease-free survival.
Material and methods. A comparative controlled study retrospectively and prospectively included 54 patients treated between 2017 and 2025 at University Clinical Hospital No.1, Sechenov University. The main group comprised 24 patients who underwent surgery via a “dismasking” bicoronal approach, while the control group included 30 patients operated on through transfacial approaches. Baseline assessment included clinicopathologic tumor characteristics, disease extent according to the 8th edition TNM classification, radicality of resection based on R-status, as well as local control, overall survival, and disease-free survival. Statistical analysis was performed using Jamovi version 2.6.45.0; differences were considered statistically significant at p<0.05.
Results. The rate of R0 resections was 75.0% (18/24) in the main group and 43.3% (13/30) in the control group (p=0.027). Local control, overall survival, and disease-free survival were estimated using the Kaplan–Meier method. In the main group, the median time to local recurrence was not reached within the follow-up period (95% CI 10–NA), whereas in the control group the median was 11 months (95% CI 6–32). The 3- and 5-year probabilities of local control in the main group were both 60% (95% CI 42–84%), compared with 10% (95% CI 3–36%) in the control group; these differences were statistically significant (log-rank p=0.025). The median overall survival was 37 months in the main group and 20 months in the control group, with no statistically significant difference (HR 0.58; 95% CI 0.27–1.27; log-rank p=0.176). The median disease-free survival was 43 months in the main group and 11 months in the control group; these differences were statistically significant (HR 0.42; 95% CI 0.19–0.92; p=0.031; log-rank p=0.025).
Conclusion. The radicality of surgical resection is a key determinant of oncologic outcome in patients with locally advanced sinonasal tumors. Use of the “dismasking” bicoronal approach in this patient population is associated with superior local disease control, primarily through achieving negative (R0) resection margins.
Keywords: sinonasal tumors; resection margin; local control; overall survival; disease-free survival
Conflicts of interest. The author have no conflicts of interest to declare.
Funding. There was no funding for this study