Impact of anatomic origin of primary squamous cell carcinomas of the nasal cavity and ethmoidal sinus on clinical outcome

Abstract

PurposeSince squamous cell carcinomas (SCCs) of the nasoethmoidal complex are rare and aggressive malignancies, the purpose of this study was to evaluate whether anatomic subsites of SCCs of the nasal cavity and ethmoid sinuses affect clinical outcome.MethodsWe retrospectively analyzed data from 47 patients with primary SCCs of the nasal cavity and ethmoid sinuses who were treated at the Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, between 1993 and 2018. The impact of anatomic subsites of nasoethmoidal SCCs was evaluated with respect to tumor and nodal classification, disease-free survival (DFS) and disease-specific survival (DSS).ResultsOf the 47 cases, 17 SCCs (36.2%) originated from lateral nasal wall followed by 13 (27.7%) tumors of the edge of naris to mucocutaneous junction, 11 (23.4%) SCCs of the nasal septum, 3 tumors of the nasal floor (6.4%) and 3 SCCs of the ethmoid sinuses (6.4%), respectively. SCCs of the nasal septum were associated with significantly higher rates of neck node metastasis (p = 0.007), which represented a significantly worse prognostic factor for DSS (HR 7.87; p < 0.001). Moreover, advanced tumor stage (HR 5.38; p = 0.014) and tumor origin of nasal septum (HR 4.05; p = 0.025) were also significantly worse prognostic factors for DSS. Fourteen patients (29.8%) developed recurrent disease, including eight local (17.0%), five regional (10.6%) and one distant (2.1%) recurrence. Elective neck dissection (ND) was associated with lower (0 vs. 20.0%) but not significantly different regional and distant DFS (p = 0.075).ConclusionAnatomic origin of nasal SCC has significant impact on clinical outcome. SCCs of the nasal septum were associated with higher rates of positive neck nodes and worse outcome.

A New Risk Score Assessment for Neck Management in T1-T2N0 Sinonasal Squamous Cell Carcinoma Patients: A European Head and Neck Cancer Center Survey Study and Evaluation of 58 Patients with Early Stage Sinonasal Carcinoma

“…Secondly, the decreased quantity of performed ENDs and thirdly the retrospective study-design including a low number of patients represent a drawback of this study. In contrast, considering the current literature regarding T1 and T2 sinonasal SCCs, published cases are ranging from 10 to 35 cases that proofs that our cohort is representative [6,9,11,17,19,30,32]. Additionally, sinonasal tumors are known to be very rare tumors with an incidence of 5.6 cases per million [30].…”

“…A more recent metaanalysis (n = 1283) has reported nodal involvement in 14.2% (range, 4-27%) of cases depending on tumor site and extension [2]. We have recently found remarkable differences regarding clinical behavior based on anatomic subsite, such as lymph node involvement and subsequently outcome in patients with SCCs of the nasoethmoidal complex [9]. Nonetheless, elective nodal treatment has no value in the current treatment of sinonasal SCCs.…”

Sinonasal carcinoma and Ohngren's line: Retrospective cohort study of 39 patients

“…Although nasoethmoidal tumours located within the nasal cavity may be detected at earlier stages making longer survival more likely, other factors also contribute to survival. For instance, it has been recently found that tumour location at the nasal septum, where early detection is common, is a negative prognostic factor due to early neck involvement 9 . Our finding that, for tumours of the nasoethmoidal complex, extension beyond OL represents a negative prognostic factor is of interest as OL has not been directly included in the staging of tumours of the nasoethmoidal complex.…”

An Aggressive Case of Sinonasal Squamous Cell Carcinoma, Invasive to Bone, Arising Within Inverted Papilloma with Intracranial Extension: A Case Report

“…Squamous cell carcinomas (SCCs) of the sinuses represent a rare and aggressive malignancy. Risk factors associated with SCCs are smoking, human papilloma virus (HPV) infection, and occupational exposure to nickel and welding fumes [1]. The standard of care is surgery, when amenable, followed by radiotherapy [2].…”

“…The clinical presentation can be very unspecific, often times it is misdiagnosed with inflammatory sinus disease, which delays treatment. Symptoms reported by patients are epistaxis, pain, swelling, foreign body sensation, and nasal obstruction, among others [1]. This disease is usually diagnosed late, when some vital structures are compromised, making the treatment more challenging.…”