Development and validation of a nomogram for prognosis of sinonasal squamous cell carcinoma

Abstract

BackgroundSinonasal squamous cell carcinoma (SNSCC) is a rare malignancy with varied outcomes. The aim of this study was to develop a nomogram for predicting survival of patients with SNSCC.MethodsFrom the Surveillance, Epidemiology, and End Results database, we identified 1766 patients diagnosed with SNSCC between 2004 and 2015. Patients were randomly separated into a training set and a validation set in 4:1 ratio. An external validation was also performed by a set of 74 SNSCC patients who had been treated in our department. We used the training set to build a nomogram based on stratified multivariable Cox proportional hazard models for predicting overall survival. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index and calibration curve.ResultsBased on 1412 cases of the training cohort, our Cox regression analysis revealed that age, marital status, primary site, differentiation, T stage, N classification, M stage, and treatment modalities were associated with overall survival. A nomogram was established based on the results of multivariate analysis. The C‐index values of the nomogram for predicting survival were superior to those of the tumor‐node‐metastasis staging system (0.745 vs 0.679 in the training cohort, 0.752 vs 0.656 in the validation set, and 0.678 vs 0.596 in the external validation set). The calibration plots demonstrated good consistency between the predicted and observed results.ConclusionWe have developed a nomogram to accurately predict the clinical outcomes of SNSCC patients. This model was effective and can help clinicians to improve patient counseling.

Malignant Sinonasal Tumors: Update on Histological and Clinical Management

“…Occupational exposure to wood dust, leather, flour, tissue, and other industrial compounds (chromium and nickel), exposure to glues, formaldehyde, and organic solvents are shown to have a causal role in the development of TuNSs in several studies. For this reason, TuNSs are officially recognized as “occupational diseases” [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Additional non-occupational risk factors for TuNSs development include tobacco, nasal polyposis, inverted sinusal papilloma [ 16 , 17 ], chronic sinusitis and, finally, radiotherapy used for the treatment of retinoblastoma, a hereditary eye tumor that generally affects children.…”

“…Squamous cell carcinoma is the most common form of TuNSs (3%) [ 10 , 15 ]. It is divided into keratinizing and non-keratinizing subtypes and generally arises from the maxillary sinus and nasal cavity.…”

“…Prognostic factors include age, performance status, tumor location and local extension, histotype, presence or lack of perineural invasion. For example, about the precise site of origin, carcinomas arising from the nasal cavity show a better prognosis than those from the paranasal sinuses, likely because nasal carcinomas give rise to symptoms (e.g., nasal obstruction or epistaxis) coming earlier to clinical attention [ 1 , 2 , 3 , 4 , 5 , 10 , 14 , 16 , 17 ]. In addition, among maxillary sinus carcinomas, those arising from the anterior-inferior portion have a better prognosis than those arising from the superior-posterior portion, likely because the latter group has easier access to structures such as the orbit or skull base.…”

Metastatic Hepatocellular Carcinoma To The Nasal Cavity And Sinus: A Potential Diagnostic Challenge And The Detection Of Programmed Death Ligand-1 Expression

“…Use of stains is especially vital in differentiating between primary sinonasal malignancies and metastatic carcinoma to the nasal cavity and sinus, as there exists signi cant histopathologic overlap between these entities. P63 and P40 stains positively in almost primary sinonasal squamous cell carcinoma which is the most common form in nasal cavity and paranasal tissues (13). The immune phenotype of the non-intestinal type sinonasal adenocarcinoma is characterized by positivity for cytokeratin 7 (14).…”

A Competing Risk Nomogram for Predicting Cancer-Specific Death of Patients With Maxillary Sinus Carcinoma

“…The incidence of MSC is second only to nasopharyngeal carcinoma and laryngeal carcinoma in China, accounting for 2%–3% of head and neck tumors. Previous studies on sinonasal malignancies using the data abstracted from the SEER data resource have focused on incidence, as well as survival patterns ( 14 , 15 ). For the first time, herein, we constructed prognostic models for the prognosis of individuals with MSC in a competitive event model and established more accurate predictors.…”