Adenoid XXXX . A histopathologic review of treatment failure patterns.

@entity1 @entity66 @entity146 @entity5 @entity189 @entity3
Seventy-one cases of adenoid @entity189 were reviewed according to treatment modality and clinical course. Thirty-six @entity1 (51%) were treated by combined surgery and radiation therapy. The @entity5 were classified by their histologic patterns into tubular, cribriform, and solid forms. Distant @entity3 , in 52%, were the most frequent and ominous sources of failure. In 35% of cases, distant @entity3 developed despite local control at the primary site. In this group, the disease had a more fulminant course with shorter survival. Histopathologically, the cribriform subtype was associated with multiple local recurrences, greater local @entity146 , and a poorer salvage rate as compared with the tubular subtype. Late onset of local recurrences and distant @entity3 was especially associated with the cribriform subtype. Overall prognosis in terms of distant @entity3 and survival was worst for the solid subtype. Control of @entity66 is best achieved with combined surgery and radiation therapy. The high incidence of distant @entity3 may not be affected by this regimen. The ultimate outcome of therapy is poorly predicted. Survival appears to be based on the pattern in which distant @entity3 develop. Overly @entity146 and mutilating surgical approaches for these @entity5 are not recommended in many instances. The need for the development of new, more effective forms of therapy is emphasized.
