Outcome for sinonasal malignancies: a population-based survey

Abstract

Purpose Sinonasal malignancies (SNM) represent a rare and complex group of cancers that includes a wide range of histopathological subtypes. Data from population-based cohorts are scarce but warranted as a basis for randomized controlled treatment trials (RCTs). Our aim was to assess overall and histology subset-specific outcomes for SNM patients treated at a tertiary referral centre. Methods A retrospective, population-based, consecutive cohort of patients with SNMs diagnosed from 2001 through 2019 was examined. Outcome was analysed in relation to age, gender, site, stage, histopathology, and treatment. Results Two-hundred and twenty-six patients were identified, whereof 61% presented with stage IV disease. 80% completed treatment with curative intent, which comprised surgery with neoadjuvant (29%) or adjuvant (37%) radiotherapy, monotherapy with surgery (22%), definitive chemoradiotherapy (7%), or radiotherapy (5%). Median follow-up was 106 months. The 5- and 10-year overall survival rates were 57% and 35%, respectively. Median overall survival was 76 months (esthesioneuroblastoma: 147 months; adenocarcinoma: 117; salivary carcinoma: 88; mucosal melanoma: 69; squamous cell carcinoma: 51, undifferentiated carcinoma: 42; neuroendocrine carcinoma: 9; and NUT-carcinoma 5). The 5- and 10-year disease-free survival rates were 63% and 54%, respectively, and disease-specific survival 83% and 66%. Increasing age, stage IVB, melanoma histopathology, and treatment with definitive chemoradiotherapy emerged as significant independent prognostic risk factors for disease-specific mortality (p ≤ 0.001). Conclusion The results indicate a seemingly good outcome in comparison to previous reports, particularly for mucosal melanoma, adenocarcinoma, and undifferentiated carcinoma. The study provides additional background for future RCTs focusing on histology subset-specific treatment for SNM.

International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

“…This finding most likely supports improved methods in diagnosis with various ancillary techniques. The mean age of the affected patients is between 49.2 and 62.5 years 1349,1404,1417,1460,1461,1463 . There seems to be a slight to marked predominance of the male sex in most studies 48,1349,1417,1460–1463 .…”

“…NUT carcinoma represents 1%–2% of SNM (Table XXIV.B.2). 1417,1418 The disease is named for its characteristic translocation of the nuclear protein on the testis (NUTM1). The previous name, NUT midline carcinoma, was changed because the tumor is not restricted to midline structures.…”

“…The mean age of the affected patients is between 49.2 and 62.5 years 1349,1404,1417,1460,1461,1463 . There seems to be a slight to marked predominance of the male sex in most studies 48,1349,1417,1460–1463 . Previous irradiation (e.g., for NPC) has been suggested as an important risk factor 1464 .…”

Current status of sinonasal cancer survivorship care

“…17 Surveillance for longer than 10 years (possibly lifelong) was proposed for certain pathologies, such as sinonasal adenoid cystic carcinoma (ACC) and olfactory neuroblastoma (ONB). 17,33,34 Sinonasal ACC have the propensity to spread hematogeneous to distant sites, with 38.1% of recurrence being attributed to distant failure and have a mean time to recurrence of 48.8 months locally and 42 months for distant metastasis (lung and brain). 35,36 ONB have a long median time to recurrence of up to 6.9 years, with locoregional recurrence being more common than distant recurrence.…”

Sinonasal NUT carcinoma: A consecutive case series and systematic review

“…While NUT carcinomas can be found in other sites of the body, NUT carcinoma most often occurs in the sinonasal tract. It has a propensity for midline structures and makes up 1%–2% of sinonasal malignancies 3,4 . In contrast to other sinonasal malignancies, NUT carcinoma typically affects younger patients.…”