The prognosis (outlook) for people with cancers of the nasal cavity and paranasal sinuses depends on many factors. These include the type of cancer, the size and location of the cancer, whether the cancer has spread to other areas of the body, and the general health of the patient. Cancers of the nasal cavity and paranasal sinuses first grow or spread locally (to nearby areas) and then spread to the lymph nodes. Lymph nodes are bean-sized glands scattered throughout the head and neck (and the rest of the body) which fight infection and remove cell waste.

Staging is a process that tells the doctor how widespread a cancer may be. It will show whether the cancer has spread and how far. The treatment and outlook for nasal cavity or paranasal sinus cancers depend, to a large extent, on their stage. For early cancer, surgery may be all that is needed. For more advanced cancer, other treatments such as chemotherapy or radiation therapy may be required. Be sure to ask your doctor to explain the stage of your cancer so that you can make the best choice for yourself about your treatment.

Nasal cavity and paranasal sinus cancers are staged using a system that is agreed upon by the American Joint Committee on Cancer (AJCC).The AJCC/TNM System describes the extent of the primary tumor (T), the absence or presence of metastasis to nearby lymph nodes (N), and the absence or presence of distant metastasis (M). Information about the T, N, and M categories is then combined by a process called stage grouping to determine the patient’s stage. This stage is described in Roman numerals from 0 to IV.

T categories for maxillary sinus cancer

TX: Primary tumor cannot be assessed

T0: No evidence of primary tumor

Tis: Cancer cells are limited to the innermost layer of the mucosa (epithelium). These cancers are known as carcinoma in situ.

T1: Tumor is only in the tissue lining the sinus (the mucosa) and does not invade bone

T2: Tumor begins to grow into some of the bones of the sinus. (Note: If the cancer grows into the bone of the back part of the sinus, it is classified as T3).

T3: Tumor begins to grow into the bone at the back of the sinus (called the posterior wall) or the tumor has grown into the ethmoid sinus, the tissues under the skin, or the eye socket.

T4a: Tumor grows into other structures such as the skin of the cheek, the front part of the eye socket, the bone at the top of the nose (cribiform plate), the sphenoid sinus, the frontal sinus, or certain parts of the face (the pterygoid plates and the infratemporal fossa). This is also known as moderately advanced local disease.

T4b: Tumor has grown into the area between the nasal cavity and the throat (called the nasopharynx), ), the back of the eye socket, the brain, the tissue covering the brain (the dura), some parts of the skull (middle cranial fossa, the clivus), or certain nerves. This is also known as very advanced local disease.

T categories for nasal cavity and ethmoid sinus cancer

TX: Primary tumor cannot be assessed

T0: No evidence of primary tumor

Tis: Cancer cells are only in the innermost layer of the mucosa (epithelium). These cancers are known as carcinoma in situ.

T1: Tumor is only in the nasal cavity or one of the ethmoid sinuses, although it may have grown into the bones of the sinus.

T2: Tumor has grown into other nasal or paranasal cavities

T3: Tumor has grown into bone of the eye socket, the roof of the mouth (palate), the cribiform plate (the bone that separates the nose from the brain), and/or the maxillary sinus

T4a: Tumor has grown into other structures such as the front part of the eye socket, the skin of the nose or cheek, the sphenoid sinus, the frontal sinus, or certain bones in the face (pterygoid plates). This is also known as moderately advanced local disease. Cancers that areT4a are resectable (meaning they can be removed with surgery)

T4b: Tumor is growing into the back of the eye socket, the brain, the dura (the tissue covering the brain), some parts of the skull (the clivus, the middle cranial fossa), certain nerves, or the nasopharynx (the area between the nasal cavity and the throat). This is also known as very advanced local disease. Tumors are called T4b when they are not resectable (they cannot be removed with surgery)

N categories

NX: Nearby (regional) lymph nodes cannot be assessed

N0: Cancer has not spread into the lymph nodes

N1: Cancer has spread to a single lymph node that is on the same side as the tumor and is no larger than 3 cm (slightly larger than 1 inch)

N2: Cancer has spread to a lymph node that is larger than 3 cm (slightly larger than one inch) but smaller than 6 centimeters (slightly larger than 2 inches); or cancer has spread to more than one lymph node which are smaller than 6 cm; or cancer is in a lymph node that is not on the same side as the tumor (and the lymph node is smaller than 6 cm).

N3: Cancer has spread to at least one nearby lymph node that is larger than 6 cm (slightly larger than 2 inches)

M categories

MX: Metastasis cannot be assessed

M0: No cancer spread (metastasis) distant organs or tissues

M1: The cancer has spread to distant organs such as the lung, brain, or liver.

Stage groupings

Survival by stage

Survival rates are often used by doctors as a standard way of discussing a person's prognosis (outlook). Some patients with cancer may want to know the survival statistics for people in similar situations, while others may not find the numbers helpful, or may even not want to know them. Whether or not you want to read about the survival statistics below for nasal and paranasal sinus cancer is up to you.

The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Of course, many people live much longer than 5 years (and many are cured).

Five-year relative survival rates assume that some people will die of other causes and compare the observed survival with that expected for people without the cancer. That means that relative survival only talks about deaths from the cancer in question. This is a more accurate way to describe the prognosis for patients with a particular type and stage of cancer.

In order to get 5-year survival rates, doctors have to look at people who were treated at least 5 years ago. Improvements in treatment since then may result in a more favorable outlook for people now being diagnosed with nasal and paranasal sinus cancer.

Survival rates are often based on previous outcomes of large numbers of people who had the disease, but they cannot predict what will happen in any particular person's case. Many other factors may affect a person's outlook, such as their general state of health, the type of cancer, and how well the cancer responds to treatment Your doctor can tell you how the numbers below may apply to you, as he or she is familiar with the aspects of your particular situation.

The following statistics come from the National Cancer Institute's SEER database and are based on cancers diagnosed between 1988 and 2001. This database does not list these cancers by AJCC stage, but instead groups them into local, regional and distant stages. Local stage means that there is no sign that the cancer has spread outside of the nose or sinus (where it started). This corresponds to AJCC stages I and II. Regional means that the cancer has started growing into nearby structure or lymph nodes. This corresponds to stages III, IVA, and IVB. Distant means that the cancer has spread to distant sites, such as the lung or liver. This corresponds to stage IVC.

For all nasal cavity and paranasal sinus cancers combined, the relative 5-year survival is 54%. Survival tends to worsen as the stage increases:

For nasal cavity cancers, survival is slightly better:

Last Medical Review: 08/13/2009
Last Revised: 08/13/2009