Morbidity and Oncological Outcome After Curative Treatment in Sinonasal Squamous Cell Carcinoma

Abstract

Objectives Sinonasal squamous cell carcinomas are rare and aggressive tumors. Curative therapy includes surgery and radiotherapy, with high risk for local morbidity and impaired quality of life. The objective of this study was to analyze a large cohort of patients with sinonasal squamous cell carcinoma on treatment morbidity and oncological outcome. Methods Patients with sinonasal squamous cell carcinoma (n = 75) treated at a tertiary referral center between 2008 and 2019 were identified. In patients with curative treatment intent (n = 70), a chart review and analysis on patient and tumor characteristics, morbidity, and oncological outcome was performed. Results Mean follow-up was 59 months. Primary curative therapy was surgery alone (n = 18), surgery with radiation (n = 25), and primary (chemo)radiation (n = 27). Forty-two (60%) patients suffered from treatment-related morbidity; most frequent symptoms were dry nasal mucosa (20%), nasal obstruction (14.3%), and vision impairment or loss (11.5%). Patients with early disease had less morbidity (51.4 vs 71.1%; P = 0.09), a lower recurrence rate (27% vs. 48.5%; P = 0.08), and better overall survival (92.5% vs. 71.1%; P = 0.01). Conclusion Treatment-related morbidity is common after curative treatment of sinonasal squamous cell carcinomas. Early disease is beneficial in terms of occurrence and severity as multimodal treatment and recurrence can more likely be avoided.

Sinonasal malignancies: Histopathological entities, regional involvement and long-term outcome

“…Few other studies present large patient cohorts of sinonasal malignancies, as most studies include only single entities (mostly SCC) and/or a single localization [ 14 , 17 , 23 , 24 ]. In this study, SCC was the most common (51.5%) entity followed by sinonasal MM, adenocarcinoma and adenoid cystic carcinoma.…”

“…In this cohort, primary loco ± regional surgery with adjuvant radiotherapy was the most common curative concept. Its effectiveness in terms of OS and local control has been demonstrated for heterogeneous cohorts of sinonasal malignancies but also specifically for SCC, MM and adenocarcinoma [ 4 – 6 , 10 , 12 , 17 , 25 ]. However, no difference in any endpoints between primary surgery (73%) and primary radiotherapy (27%) could be demonstrated in this cohort.…”

“…Isolated regional recurrence is rare and little evidence is available demonstrating possible risk factors [ 1 ]. Beneficial factors for OS are negative surgical margins and multimodal therapy, as well as initial cN0 status [ 2 , 17 ].…”

Diagnóstico E Manejo De Carcinoma De Células Escamosas Sinonasal Não Queratinizante: Relato De Caso

“…1 O carcinoma de células escamosas (CCE) é o tipo de câncer mais frequente na cavidade nasal e nos seios paranasais, representando 3% de todos os cânceres de cabeça e pescoço e caracterizada por seu comportamento agressivo. 2 O carcinoma de células escamosas sinonasal (CCES) é uma neoplasia epitelial maligna que se origina do epitélio de superfície e apresenta, basicamente, dois subtipos: queratinizante e não-queratinizante. Afeta predominantemente homens entre a 6ª e 7ª década de vida e surge, principalmente, em seio maxilar, seios etmoidais e cavidade nasal.…”

“…1 Pacientes acometidos pelo CCES usualmente cursam com obstrução nasal, rinorreia, dor facial/cefaléia, epistaxe, aumento de volume e possível expansão para as estruturas orais. 1,2 Exposição ao trabalho com pó de madeira e couro, exposição ao níquel, infecção pelo vírus Epstein-Barr, papiloma vírus humano, histórico de radioterapia para retinoblastoma são fatores de risco descritos e associados ao surgimento dessa condição. 2 Em razão da proximidade anatômica entre as estruturas sinonasais e a cavidade bucal, algumas NMS podem se estender para as estruturas orais.…”