Should an elective neck dissection be performed for maxillary sinus squamous cell carcinoma?

Berger, Michael; Tajudeen, Bobby A.; John, Maie A. St.; Tjoa, Tjoson; Kuan, Edward C.

doi:10.1002/lary.28242

Cited by 12 publications

(17 citation statements)

References 5 publications

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“…On the other hand, several papers have suggested that elective treatment of the neck can be considered justifiable in case of advanced-stage SCC (T3-T4), given the relatively high incidence rate of regional failure (3-20%). 7,8,39 In addition, a recent meta-analysis on sinonasal undifferentiated carcinoma showed a significantly reduced risk of regional recurrence in patients who underwent elective treatment of the neck. 40 However, the practice to not systematically perform END in sinonasal SCC is naturally shifted to the SNMM management.…”

Section: Discussionmentioning

confidence: 99%

Regional disease control in sinonasal mucosal melanoma: Systematic review and meta‐analysis

et al. 2020

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To systematically analyze the regional disease control after sinonasal mucosal melanoma (SNMM) primary treatment. Methods: The study was performed according to the PRISMA guidelines searching on Scopus, PubMed/MEDLINE, Cochrane Library, and Google Scholar databases. Results: A total of 15 studies with 936 patients (median age: 68.0 years, IQR 65-71) were included. Overall, the cumulative regional recurrence rate (RRR) was 18.4% (n = 917, 99% CI: 14.0%-23.4%), with a median follow-up of 30.0 months (n = 765, IQR 22.0-37.0). The RRR in clinical node negative patients was 17.0% (99% CI: 12.2%-22.5%), with a median follow-up of 22.0 months (n = 327, IQR 21.5-31.5). Conclusions: The RRR of SNMM after primary treatment is not to be neglected. Further prospective studies should be encouraged to clarify if elective treatment of the neck could be recommended at least in a subgroup of patients.

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Section: Discussionmentioning

confidence: 99%

Regional disease control in sinonasal mucosal melanoma: Systematic review and meta‐analysis

et al. 2020

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“…Berger et al [ 130 ] recently summed up the findings from four retrospective cohort studies [ 126 , 128 , 131 , 132 ] and one review [ 133 ] on elective neck dissection in cN0 SCCs of the maxillary sinus, stating that strong recommendations cannot be made for upfront elective neck dissection, as evidence and conclusions are heterogenous and there is a lack of prospective trials. Overall, they concluded that elective neck dissection or treatment of the neck should be considered for higher T categories (i.e., cT3-4), or when the neck is accessed to harvest the recipient vessels for a microvascular reconstruction.…”

Section: Treatmentmentioning

confidence: 99%

Sinonasal Squamous Cell Carcinoma, a Narrative Reappraisal of the Current Evidence

Ferrari

Taboni

Carobbio

et al. 2021

Cancers

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Sinonasal squamous cell carcinoma is a rare tumor affecting the nasal cavity and paranasal sinuses. Several aspects of this disease, ranging from epidemiology to biology, pathology, diagnosis, staging, treatment, and post-treatment surveillance are controversial, and consensus on how to manage this sinonasal cancer is lacking. A narrative literature review was performed to summarize the current evidence and provide the reader with available data supporting the decision-making process in patients affected by sinonasal squamous cell carcinoma, alongside the authors’ personal opinion on the unsolved issues of this tumor. The review has highlighted several advances in molecular definition of epithelial cancers of the sinonasal tract. Surgery represents the pivot of treatment and is performed through an endoscopic transnasal approach whenever feasible. Open surgery is required for a large proportion of cases. Reconstruction of the defect follows principles of skull base and cranio-maxillo-facial reconstruction. Chemotherapy is given as neoadjuvant treatment or concomitantly to radiotherapy. Photon-based radiation therapy has a crucial role in the adjuvant setting. Particle therapy is providing promising results. Management of the neck should be planned based on the presence of clinically appreciable metastases, primary tumor extension, and need for recipient vessels. Biotherapy and immunotherapy are still underexplored therapeutical modalities.

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“…No literature is published in these early stages, but overall, for all tumor stages, the rate of occult metastasis ranges from 13.5 -22.2% [13]. Though occult metastasis seems to be rare in T1 and T2 sinonasal SCCs, the regional control was signi cantly better in patients who had received elective neck treatment [12,14,16]. Several studies could underline the fact that END is linked to decreasing regional recurrent disease, but is rather recommended in higher stages [13,17,19].…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, elective neck treatment was associated with better prognosis in higher stage maxillary sinus SCCs [13,14,15]. Hence, one of the purposes of the study was the evaluation of current treatment concepts of stage I (T1N0) and II (T2N0) sinonasal SCCs in Europe and whether or not the anatomic subsites in uence treatment decisions and oncological outcome using an online survey (see supplementary material).…”

Section: Introductionmentioning

confidence: 99%

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

Lill¹,

Erović²,

Seemann³

et al. 2021

Preprint

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Purpose The purpose of the present study was to assess whether European head and neck cancer centers perform elective neck dissection (END) in early stage sinonasal squamous cell carcinomas (SCCs) and whether END affects oncological outcome. Methods A questionnaire regarding performance of END in T1 - T2 sinonasal SCCs was sent to 38 head and neck cancer centers in Europe. The results were further correlated and compared with clinical data of 58 patients with T1 (n = 37) and T2 (n = 21) sinonasal SCCs, a risk score and a nomogram were generated. Results Only 5–10 % of respondents are performing END in T1 and 26–32% in T2 sinonasal SCCs. In our cohort regional recurrence was evident in 10 (17.2%) patients, representing a significant worse prognostic factor for cancer specific survival (HR 8.13; p = 0.016). Particularly, regional recurrence was more frequent in T2 tumors and in patients where the primary tumor originated from nasal septum and vestibule. Based on our clinical and questionnaire data a new risk-score was determined to predict necessity for END. The risk-score, including T-classification and tumor site, assigned T1-classification with 0 points, followed by 1 point for T2; tumor site: nasal septum or vestibule with 1 point and tumors from other subsites with 0 points. Based on these factors we further created a nomogram for predicting the risk of regional recurrence. Patients with a high-risk score showed 9.52-fold higher risk for regional and or distant recurrence (HR 9.52; p = 0.002;) and their 5-year CSS was 44.4% compared to 92.8% in patients with moderate or low risk (p = 0.017). Conclusions Our proposed risk-score system in T1-2N0 sinonasal carcinoma is helpful to identify patients who may benefit from END. Although to date END has no value in European head and neck cancer centers for T1-T2 sinonasal SCCs, our study indicates that the neck management in these patients should be reconsidered.

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Should an elective neck dissection be performed for maxillary sinus squamous cell carcinoma?

Cited by 12 publications

References 5 publications

Regional disease control in sinonasal mucosal melanoma: Systematic review and meta‐analysis

Regional disease control in sinonasal mucosal melanoma: Systematic review and meta‐analysis

Sinonasal Squamous Cell Carcinoma, a Narrative Reappraisal of the Current Evidence

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

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