T stage as prognostic factor in irradiated localized squamous cell carcinoma of the nasal vestibule

BACKGROUND: To investigate the impact of T stage according to Wang on the prognosis of irradiated nasal vestibule carcinoma. PATIENTS AND METHODS: Treatment results of 47 patients were retrospectively analyzed. Treatment consisted of external beam radiotherapy (n = 26) or interstitial radiotherapy (n = 19) or a combination of both (n = 2) for a primary, localized, squamous cell carcinoma of the nasal vestibule. Mean follow-up was 5 years and 7 months. RESULTS: T1/T2 tumors: Local control was achieved in 40 of 44 patients; surgical salvage was possible in 2 of 4 local failures. Five patients had recurrences in the neck, and four of them could be salvaged surgically. One patient had distant metastases develop. T3 tumors (n = 3): no T3 tumor could locally be cured by radiotherapy. One patient was salvaged surgically but died of regional and distant metastases. Disease-specific survival is significantly correlated with T stage according to Wang (p =.0001). Most (85%) patients were smokers, and eight of them (20%) had a second primary tumor develop in the lungs. CONCLUSIONS: The effect of radiotherapy is significantly correlated with T stage (p =.0001) and hence less successful in T3 lesions as primary treatment option. The high incidence of second primary tumors in the lung is indicative for a similar carcinogenic influence of smoking on the nasal vestibule.