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Wang L, Wang J, Wang T, Li Y, Song X. The Role of Elective Nodal Irradiation in Treating Clinically Node-Negative Sinonasal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2024:S0360-3016(24)00695-3. [PMID: 38862085 DOI: 10.1016/j.ijrobp.2024.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 05/16/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE This study aims to examine the role of elective nodal irradiation (ENI) in clinically node-negative (cN0) sinonasal squamous cell carcinoma (SNSCC) and to define the optimal radiation fields for ENI. METHODS AND MATERIALS We retrospectively reviewed 368 patients with cN0 SNSCC treated between 2009 and 2021. The study evaluated the impact of ENI on overall survival, progression-free survival, regional failure-free survival, and distant metastasis-free survival, along with the coverage areas of ENI. RESULTS The majority of patients underwent surgery (316/368, 85.9%), with 276 of 368 (75%) having tumors in the maxillary sinus or nasal cavity and 249 of 368 (67.7%) presenting with T4 disease. Additionally, in 119 of the 368 cases (32.3%), tumors were poorly differentiated. The 5-year overall survival, progression-free survival, regional failure-free survival, and distant metastasis-free survival rates were 59.3%, 54.0%, 57.6%, and 58.8%, respectively. ENI was performed in 217 patients (59%), with 16 experiencing neck relapse during follow-up. Although ENI did not enhance survival rates, it significantly reduced the overall regional failure rate (7.9% vs 1.8%; χ2 = 7.98; P < .01) and the cumulative incidence of regional failure (P = .045). Additionally, the subgroups with maxillary sinus origin (2.3% vs 13.5%; P = .025), T4 stage (1.8% vs 8.5%; P = .028), and poor differentiation (2.4% vs 13.5%; P = .029) had higher cumulative incidences of regional failure in patients without ENI. No significant difference was observed in survival and regional failure rates between patients treated with ENI to levels Ib and II with or without level III, as well as between cN0 patients with nonmidline crossing lesions receiving unilateral or bilateral ENI. CONCLUSIONS Despite no survival benefit, ENI significantly decreases the regional failure rate in patients with cN0 SNSCC. For primary lesions not crossing the midline, ipsilateral ENI targeting levels Ib and II proves to be an effective strategy.
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Affiliation(s)
- Li Wang
- Department of Radiation Oncology, Eye & Ear Nose Throat Hospital, Fudan University, Shanghai, China
| | - Jie Wang
- Department of Radiation Oncology, Eye & Ear Nose Throat Hospital, Fudan University, Shanghai, China
| | - Tian Wang
- Department of Radiation Oncology, Eye & Ear Nose Throat Hospital, Fudan University, Shanghai, China
| | - Yi Li
- Department of Oncology, 920th Hospital of Joint Logistics Support Force, Kunming, China.
| | - Xinmao Song
- Department of Radiation Oncology, Eye & Ear Nose Throat Hospital, Fudan University, Shanghai, China.
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Bussu F, Tagliaferri L, Corbisiero MF, Lotto C, Pellini R, Guarino P, Mercante G, Galuppi A, Cariti F, Almadori G, Longo F, Calabrese L, Galli J, Presutti L, Nicolai P, Molteni G. Management of nasal vestibule carcinomas: recommendations by the Oncological Committee of the Italian Society of Otorhinolaryngology - Head and Neck Surgery. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2024; 44:13-20. [PMID: 38420717 PMCID: PMC10914357 DOI: 10.14639/0392-100x-n2786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/28/2023] [Indexed: 03/02/2024]
Abstract
Objective Squamous cell carcinoma of the nasal vestibule (NV SCC) is a head and neck malignancy for which there is no established consensus on most aspects of clinical management. The purpose of this document is to give updated recommendations that incorporate recent evidence on its clinical characteristics and the high efficacy of brachytherapy as primary treatment modality. Methods A working group consisting of the members of the Scientific Committee for Oncology and Reconstructive Surgery of the Italian Society of Otorhinolaryngology Head and Neck Surgery and radiation oncologists expert in brachytherapy was formed to achieve a consensus. Results Consensus was reached on a set of recommendations, proposing a refined anatomical definition of the nasal vestibule, a novel T staging system of the NV SCC, and brachytherapy as standard of care, with a new method for catheter implantation. Conclusions The Committee emphasises the critical role of an accurate classification in clinical practice and encourages further research to validate the novel staging system and further improve treatment strategies. Where appropriate, it is recommended that patients be referred to centres with specific experience in brachytherapy for NV SCC.
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Affiliation(s)
- Francesco Bussu
- Department of Medicine, Surgery and Pharmacy, Sassari University, Italy
- Otolaryngology Division, Sassari University Hospital, Sassaey, Italy
| | - Luca Tagliaferri
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Rome, Italy
| | | | - Cecilia Lotto
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Otolaryngology and Audiology Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Raul Pellini
- Head and Neck Department, IRCCS National Cancer Institute “Regina Elena” Rome, Italy
| | - Pierre Guarino
- Otorhinolaryngology Head and Neck Surgery Unit, “Santo Spirito” Hospital of Pescara, Pescara, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Otorhinolaryngology - Head and Neck Surgery, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Andrea Galuppi
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, DIMES, Alma Mater Studiorum, Bologna University, Bologna, Italy
| | - Francesco Cariti
- Department of Otolaryngology Head and Neck Surgery, “Mons. Dimiccoli” Hospital, Barletta, Italy
| | - Giovanni Almadori
- Unit of Head and Neck Surgical Oncology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Longo
- Maxillofacial & ENT Surgery Unit, Department of Head and Neck Surgery and Oncology, Istituto Nazionale Tumori IRCCS Fondazione “G. Pascale”, Naples, Italy
| | - Luca Calabrese
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), Bolzano, Italy
| | - Jacopo Galli
- Unit of Otolaryngology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Livio Presutti
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Otolaryngology and Audiology Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Piero Nicolai
- Section of Otorhinolaryngology - Head & Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Gabriele Molteni
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Otolaryngology and Audiology Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
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3
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Tsuda T, Fukusumi T, Saito M, Kuki A, Inohara H. Microscopic Residual Disease After Nasal Squamous Cell Carcinoma Not Visualized on FDG PET-CT: A Case Report. Cureus 2023; 15:e47451. [PMID: 38022262 PMCID: PMC10660082 DOI: 10.7759/cureus.47451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
Nasal squamous cell carcinoma (SCC) is rare and aggressive. It often requires combination treatment. Precise post-treatment disease assessment is vital for determining the subsequent management and prognosis. We present the intriguing case of a 52-year-old man with T4bN0M0 stage IVB SCC. Post-treatment fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) findings indicated a complete response; however, microscopic remnants of the cancer were detected during endoscopic sinus surgery. This report underscores the limitations of post-treatment assessment using FDG PET-CT and outpatient endoscopy alone due to these modalities' potential inability to detect microscopic residual disease. Endoscopic sinus surgery should be incorporated into routine post-treatment assessments of nasal SCC to improve disease detection and guide further treatment. Further large-scale studies are required to confirm these findings.
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Affiliation(s)
- Takeshi Tsuda
- Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita-city, Osaka, JPN
| | - Takahito Fukusumi
- Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita-city, Osaka, JPN
| | - Miyu Saito
- Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita-city, Osaka, JPN
| | - Atsuto Kuki
- Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita-city, Osaka, JPN
| | - Hidenori Inohara
- Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita-city, Osaka, JPN
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4
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Hamilton SN, Liu J, Holmes C, DeVries K, Olson R, Tran E, Berthelet E, Wu J, Chau N, Chan M, Thamboo A. Population-based Long-term Outcomes for Squamous Cell Carcinoma of the Nasal Cavity. Am J Clin Oncol 2023; 46:199-205. [PMID: 36882926 DOI: 10.1097/coc.0000000000000992] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND This study evaluates population-based outcomes of patients with squamous cell carcinoma (SCC) of the nasal cavity treated in British Columbia. METHODS A retrospective review of nasal cavity SCC treated from 1984 to 2014 was performed (n = 159). Locoregional recurrence (LRR) and overall survival (OS) were evaluated. RESULTS The 3-year OS was 74.2% for radiation alone, 75.8% for surgery alone, and 78.4% for surgery and radiation ( P = 0.16). The 3-year LRR was 28.4% for radiation alone, 28.2% for surgery alone, and 22.6% for surgery and radiation ( P = 0.21). On multivariable analysis, surgery and postoperative radiation relative to surgery alone was associated with a lower risk of LRR (hazard ratio: 0.36, P = 0.03). Poor Eastern Cooperative Oncology Group status, node-positive, orbital invasion, smoking, and advanced age were associated with worse OS (all P <0.05). CONCLUSION In this population-based analysis, multimodality treatment with surgery and adjuvant radiation were associated with improved locoregional control for SCC of the nasal cavity.
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Affiliation(s)
| | | | - Connor Holmes
- Department of Otolaryngology
- University of British Columbia
| | | | - Robert Olson
- Department of Surgery
- Department of Radiation Oncology, British Columbia Cancer-Centre for the North, Prince George, BC, Canada
| | - Eric Tran
- Department of Surgery
- Department of Radiation Oncology
| | | | - Jonn Wu
- Department of Surgery
- Department of Radiation Oncology
| | - Nicole Chau
- Department of Surgery
- Department of Medical Oncology, British Columbia Cancer-Vancouver Centre, Vancouver
| | - Matthew Chan
- Department of Surgery
- Department of Radiation Oncology
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Issa K, Teitelbaum J, Smith BD, Wang F, Ackall F, Sargi Z, Rangarajan SV, Jung SH, Jang DW, Abi Hachem R. Nasal Cavity Squamous Cell Carcinoma: Factors Associated With Treatment Outcomes and Potential Organ Preservation. Am J Rhinol Allergy 2022; 37:35-42. [DOI: 10.1177/19458924221130133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Squamous cell carcinoma of the nasal cavity (NCSCC) is a rare, challenging malignancy. Surgical resection of this tumor can cause significant facial deformity, and indications for adjuvant or organ preservation therapies are not well-described. Objective To examine the impact of treatment regimen on survival outcomes in NCSCC and to compare surgical to non-surgical based therapies. Methods The National Cancer Database was queried for NCSCC from 2004 to 2014. Patient demographics, tumor characteristics, and treatment regimen were compared for the entire cohort. Multivariable Cox proportional hazards regression was performed for statistical analysis of treatment regimen and surgical margins on overall survival (OS) for early and late-stage disease. Results A total of 1883 NCSCC patients were identified. The OS for the cohort was 83 months, and median age at diagnosis was 65 years. NCSCC patients who underwent surgery followed by adjuvant radiation therapy (RT) had a better OS compared to definitive RT (HR: 0.58, P < .001). In early stage NCSCC (T1/T2, N0), there was no significant difference in OS between patients treated with surgery only or surgery with adjuvant RT compared to definitive RT. In advanced stage NCSCC, surgery with adjuvant RT had a better OS compared to definitive chemoradiation. Having positive margins was shown to predict a worse OS when compared to negative margins in surgical patients despite adjuvant RT or chemoradiation. Conclusions NCSCC appears to be best treated with surgery followed by adjuvant RT in advanced-stage disease whereas in early-stage disease, surgery does not improve OS compared to definitive RT.
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Affiliation(s)
- Khalil Issa
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| | - Jordan Teitelbaum
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| | - Blaine D. Smith
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| | - Frances Wang
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Feras Ackall
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| | - Zoukaa Sargi
- Department of Otolaryngology, University of Miami, Miami, Florida
| | - Sanjeet V. Rangarajan
- Department of Otolaryngology and Head and Neck Surgery, The University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - Sin-Ho Jung
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - David W Jang
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
| | - Ralph Abi Hachem
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina
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6
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Schneider TA, Gryn O, Lutz M. A Case of Squamous Cell Carcinoma of the Nasal Cavity Treated With Total Rhinectomy. Cureus 2022; 14:e23576. [PMID: 35494922 PMCID: PMC9045844 DOI: 10.7759/cureus.23576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
Squamous cell carcinoma of the nasal cavity is a relatively rare cancer. Five-year recurrence-free survival rates have a large range, which may be due to the small patient population available to study. Recurrence rates vary based on the treatment regimen and aggressiveness of the surgical approach. Total rhinectomy is not often performed due to its invasive nature and extensiveness of reconstruction required afterward. This report will cover a patient who presented with squamous cell carcinoma of the left nasal vestibule and was treated with total rhinectomy and radiation therapy.
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7
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Meerwein CM, Balermpas P, Vital DG, Broglie MA, Soyka MB, Holzmann D. The Role of Regional Disease and Patterns of Treatment Failure in Primary Sinonasal Malignancies. Am J Rhinol Allergy 2021; 36:157-166. [PMID: 34292084 PMCID: PMC8652360 DOI: 10.1177/19458924211033402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background The question how to treat the clinically negative neck in sinonasal malignancies is controversial. Objectives To investigate patterns of treatment failure and to assess outcome measures in patients with primary sinonasal malignancies. Methods Retrospective cohort study of patients treated for primary malignant sinonasal malignancies. Results Lymph node (LN) metastases at initial presentation were present in 8 of 152 patients (5.3%). Ipsi- and contralateral LN levels 1 and 2 were identified as nodal basins at risk. We found a 5-year overall survival (OS) of 75.2% and disease free survival of 61.1%. Among patients with cN0 neck, nodal recurrence free survival was not different between patients with and without elective neck treatment (P = .23). On logistic regression analysis, we found initial T classification as an independent factor for achievement of complete remission (CR) and OS. Conclusions LN metastases at initial presentation are rare and initial T classification was identified as the most important prognostic factor for OS and CR, emphasizing the need for a thorough initial staging of the primary tumor.
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Affiliation(s)
- Christian M Meerwein
- Department of Otorhinolaryngology, Head & Neck Surgery, 27243University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Panagiotis Balermpas
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Domenic G Vital
- Department of Otorhinolaryngology, Head & Neck Surgery, 27243University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology, Head & Neck Surgery, 27243University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael B Soyka
- Department of Otorhinolaryngology, Head & Neck Surgery, 27243University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology, Head & Neck Surgery, 27243University Hospital Zurich, University of Zurich, Zurich, Switzerland
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8
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Nguyen ES, Risbud A, Birkenbeuel JL, Murphy LS, Goshtasbi K, Pang JC, Abiri A, Lehrich BM, Haidar YM, Tjoa T, Kuan EC. Prognostic Factors and Outcomes of De Novo Sinonasal Squamous Cell Carcinoma: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2021; 166:434-443. [PMID: 34253092 DOI: 10.1177/01945998211021023] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To review overall survival (OS), recurrence patterns, and prognostic factors of de novo sinonasal squamous cell carcinoma (DN-SCC). DATA SOURCES PubMed, Scopus, OVID Medline, and Cochrane databases from 2006 to December 23, 2020. REVIEW METHODS The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Articles were required to report either recurrence patterns or survival outcomes of adults with DN-SCC. Case reports, books, reviews, meta-analyses, and database studies were all excluded. RESULTS Forty-one studies reported on survival or recurrence outcomes. The aggregate 5-year OS was 54.5% (range, 18%-75%) from 35 studies (n = 1903). Patients undergoing open surgery were more likely to receive radiation therapy and present at an advanced stage compared to those receiving endoscopic surgery (all P < .001). Advanced T stage, presence of cervical nodal metastases, maxillary sinus primary site, and negative human papillomavirus (HPV) status were all correlated with significantly worse 5-year OS. Direct meta-analysis of 8 studies demonstrated patients with surgery were more likely to be alive at 5 years compared to those who did not receive surgery (odds ratio, 2.26; 95% CI, 1.48-3.47; P < .001). Recurrence was reported in 628 of 1471 patients from 26 studies (42.7%) with an aggregate 5-year locoregional control rate of 67.1% (range, 50.4%-93.3%). CONCLUSION This systematic review and meta-analysis suggests that the 5-year OS rate for DN-SCC may approach 54.5% and recurrence rate approaches 42.7%. In addition, various tumor characteristics including advanced T stage, positive nodal status, maxillary sinus origin, and negative HPV status are all associated with decreased survival.
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Affiliation(s)
- Emily S Nguyen
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Adwight Risbud
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Jack L Birkenbeuel
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Linda S Murphy
- Science Library Reference Department, University of California, Irvine, California, USA
| | - Khodayar Goshtasbi
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Jonathan C Pang
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Arash Abiri
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Brandon M Lehrich
- Medical Scientist Training Program, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Yarah M Haidar
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Tjoson Tjoa
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
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9
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Chabrillac E, Talawdekar A, Garikipati S, Varley I, Sionis S, Beasley N, Jackson R. A single centre's experience of 23 cases of total rhinectomy for the treatment of squamous cell carcinoma involving the nasal vestibule. Eur Arch Otorhinolaryngol 2021; 279:2069-2075. [PMID: 34223976 DOI: 10.1007/s00405-021-06972-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 06/27/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aims to analyse the oncological outcomes of total rhinectomy (TR) for squamous cell carcinomas (SCCs) involving the nasal vestibule, and to identify prognostic factors for disease recurrence. METHODS A retrospective single-centre study was conducted between September 2003 and February 2021 including all patients who underwent a TR for a SCC involving the nasal vestibule. RESULTS 23 patients were included in the study. Tumours originated from the anterior septum (n = 12), vestibule (n = 8) or skin (n = 3). Six TRs (26.1%) were salvage procedures, after primary radiotherapy or partial rhinectomy. Seven patients had a concurrent neck dissection and 17 patients (73.9%) received adjuvant treatment (14 patients had radiotherapy and 3 had chemoradiotherapy). After a median follow-up of 32 months, six patients (26.1%) presented with tumour recurrence. Three patients (13%) had nodal-only recurrence. The estimated 5-year overall survival, disease-free survival and disease-specific survival were 67.5%, 66.3% and 80.7%, respectively. Positive excision margins were a predictive factor for tumour recurrence (p = 0.0401). CONCLUSION For SCCs involving the nasal vestibule that are not amenable to limited surgical resection, TR along with adjuvant radiotherapy provide good oncological outcomes and should be considered the main treatment option.
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Affiliation(s)
- Emilien Chabrillac
- Department of Ear, Nose and Throat Surgery, Sheffield Teaching Hospitals Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Broomhall, Sheffield, S10 2JF, UK. .,Department of Surgery, University Cancer Institute Toulouse-Oncopole, Toulouse, France.
| | - Ashish Talawdekar
- Department of Ear, Nose and Throat Surgery, Sheffield Teaching Hospitals Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Broomhall, Sheffield, S10 2JF, UK
| | | | - Iain Varley
- Department of Oral and Maxillo-Facial Surgery, Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
| | - Sara Sionis
- Department of Ear, Nose and Throat Surgery, Sheffield Teaching Hospitals Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Broomhall, Sheffield, S10 2JF, UK
| | - Nigel Beasley
- Department of Ear, Nose and Throat Surgery, Sheffield Teaching Hospitals Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Broomhall, Sheffield, S10 2JF, UK
| | - Richard Jackson
- Department of Ear, Nose and Throat Surgery, Sheffield Teaching Hospitals Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Broomhall, Sheffield, S10 2JF, UK
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10
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Pisani P, Airoldi M, Allais A, Aluffi Valletti P, Battista M, Benazzo M, Briatore R, Cacciola S, Cocuzza S, Colombo A, Conti B, Costanzo A, della Vecchia L, Denaro N, Fantozzi C, Galizia D, Garzaro M, Genta I, Iasi GA, Krengli M, Landolfo V, Lanza GV, Magnano M, Mancuso M, Maroldi R, Masini L, Merlano MC, Piemonte M, Pisani S, Prina-Mello A, Prioglio L, Rugiu MG, Scasso F, Serra A, Valente G, Zannetti M, Zigliani A. Metastatic disease in head & neck oncology. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2020; 40:S1-S86. [PMID: 32469009 PMCID: PMC7263073 DOI: 10.14639/0392-100x-suppl.1-40-2020] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The head and neck district represents one of the most frequent sites of cancer, and the percentage of metastases is very high in both loco-regional and distant areas. Prognosis refers to several factors: a) stage of disease; b) loco-regional relapses; c) distant metastasis. At diagnosis, distant metastases of head and neck cancers are present in about 10% of cases with an additional 20-30% developing metastases during the course of their disease. Diagnosis of distant metastases is associated with unfavorable prognosis, with a median survival of about 10 months. The aim of the present review is to provide an update on distant metastasis in head and neck oncology. Recent achievements in molecular profiling, interaction between neoplastic tissue and the tumor microenvironment, oligometastatic disease concepts, and the role of immunotherapy have all deeply changed the therapeutic approach and disease control. Firstly, we approach topics such as natural history, epidemiology of distant metastases and relevant pathological and radiological aspects. Focus is then placed on the most relevant clinical aspects; particular attention is reserved to tumours with distant metastasis and positive for EBV and HPV, and the oligometastatic concept. A substantial part of the review is dedicated to different therapeutic approaches. We highlight the role of immunotherapy and the potential effects of innovative technologies. Lastly, we present ethical and clinical perspectives related to frailty in oncological patients and emerging difficulties in sustainable socio-economical governance.
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Affiliation(s)
- Paolo Pisani
- ENT Unit, ASL AT, “Cardinal Massaja” Hospital, Asti, Italy
| | - Mario Airoldi
- Medical Oncology, Città della Salute e della Scienza, Torino, Italy
| | | | - Paolo Aluffi Valletti
- SCDU Otorinolaringoiatria, AOU Maggiore della Carità di Novara, Università del Piemonte Orientale, Italy
| | | | - Marco Benazzo
- SC Otorinolaringoiatria, Fondazione IRCCS Policlinico “S. Matteo”, Università di Pavia, Italy
| | | | | | - Salvatore Cocuzza
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Italy
| | - Andrea Colombo
- ENT Unit, ASL AT, “Cardinal Massaja” Hospital, Asti, Italy
| | - Bice Conti
- Department of Drug Sciences, University of Pavia, Italy
- Polymerix S.r.L., Pavia, Italy
| | | | - Laura della Vecchia
- Unit of Otorhinolaryngology General Hospital “Macchi”, ASST dei Settelaghi, Varese, Italy
| | - Nerina Denaro
- Oncology Department A.O.S. Croce & Carle, Cuneo, Italy
| | | | - Danilo Galizia
- Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo,Italy
| | - Massimiliano Garzaro
- SCDU Otorinolaringoiatria, AOU Maggiore della Carità di Novara, Università del Piemonte Orientale, Italy
| | - Ida Genta
- Department of Drug Sciences, University of Pavia, Italy
- Polymerix S.r.L., Pavia, Italy
| | | | - Marco Krengli
- Dipartimento Medico Specialistico ed Oncologico, SC Radioterapia Oncologica, AOU Maggiore della Carità, Novara, Italy
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, Novara, Italy
| | | | - Giovanni Vittorio Lanza
- S.O.C. Chirurgia Toracica, Azienda Ospedaliera Nazionale “SS. Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | | | - Maurizio Mancuso
- S.O.C. Chirurgia Toracica, Azienda Ospedaliera Nazionale “SS. Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Roberto Maroldi
- Department of Radiology, University of Brescia, ASST Spedali Civili Brescia, Italy
| | - Laura Masini
- Dipartimento Medico Specialistico ed Oncologico, SC Radioterapia Oncologica, AOU Maggiore della Carità, Novara, Italy
| | - Marco Carlo Merlano
- Oncology Department A.O.S. Croce & Carle, Cuneo, Italy
- Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo,Italy
| | - Marco Piemonte
- ENT Unit, University Hospital “Santa Maria della Misericordia”, Udine, Italy
| | - Silvia Pisani
- Immunology and Transplantation Laboratory Fondazione IRCCS Policlinico “S. Matteo”, Pavia, Italy
| | - Adriele Prina-Mello
- LBCAM, Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin 8, Ireland
- Centre for Research on Adaptive Nanostructures and Nanodevices (CRANN), Trinity College Dublin, Dublin 2, Ireland
| | - Luca Prioglio
- Department of Otorhinolaryngology, ASL 3 “Genovese”, “Padre Antero Micone” Hospital, Genoa, Italy
| | | | - Felice Scasso
- Department of Otorhinolaryngology, ASL 3 “Genovese”, “Padre Antero Micone” Hospital, Genoa, Italy
| | - Agostino Serra
- University of Catania, Italy
- G.B. Morgagni Foundation, Catania, Italy
| | - Guido Valente
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, Novara, Italy
| | - Micol Zannetti
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, Novara, Italy
| | - Angelo Zigliani
- Department of Radiology, University of Brescia, ASST Spedali Civili Brescia, Italy
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11
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Ranasinghe VJ, Stubbs VC, Reny DC, Fathy R, Brant JA, Newman JG. Predictors of nodal metastasis in sinonasal squamous cell carcinoma: A national cancer database analysis. World J Otorhinolaryngol Head Neck Surg 2020; 6:137-141. [PMID: 32596660 PMCID: PMC7296471 DOI: 10.1016/j.wjorl.2020.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 01/19/2020] [Indexed: 02/03/2023] Open
Abstract
Objective We present the largest population based study of sinonasal squamous cell carcinoma (SCC) to identify risk factors for presentation with nodal metastasis. Methods The National Cancer Database (NCDB) was used for this study. Location codes corresponding to the nasal cavity and paranasal sinuses and histology codes representing SCC malignancy were queried. Logistic regression analysis was performed to identify factors associated with presentation with nodal metastasis. Results 6448 cases met inclusion criteria. Nodal metastasis at presentation was seen in 13.2% of patients, with the sinus subsite (19.3%) being a significant risk factor for nodal metastasis at presentation when compared to the nasal cavity (7.9%). Logistic regression analysis showed black, uninsured and Medicaid patients were more likely than white and privately insured patients, respectively, to present with nodal metastasis. Conclusions In sinonasal SCC, the sinus subsite has a significantly increased risk of nodal metastasis compared to the nasal cavity. Black race, uninsured and Medicaid patients are more likely to have nodal metastasis at presentation.
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Affiliation(s)
- Viran J Ranasinghe
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Vanessa C Stubbs
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Danielle C Reny
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Ramie Fathy
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jason A Brant
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Jason G Newman
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States
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Qian Y, Teng Y, Li Y, Lin X, Guan M, Li Y, Cao X, Gao Y. MiR-143-3p suppresses the progression of nasal squamous cell carcinoma by targeting Bcl-2 and IGF1R. Biochem Biophys Res Commun 2019; 518:492-499. [PMID: 31443963 DOI: 10.1016/j.bbrc.2019.08.075] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 08/13/2019] [Indexed: 12/30/2022]
Abstract
Dysregulated microRNAs (miRNAs) play crucial roles in the occurrence and development of multiple tumours, but their roles in the progression of nasal squamous cell carcinoma (NSCC) remain unknown. The aim of our study was to investigate the potential function and molecular mechanism of miR-143-3p in NSCC. Expression of miRNA and mRNA was detected by quantitative real-time reverse transcription-PCR (qRT-PCR). Forced overexpression of miR-143-3p was established by transfecting mimics into NSCC cell line. Then, we investigated the role of miR-143-3p in human NSCC cell proliferation, apoptosis, cycle and migration by using MTT, flow cytometry and transwell assays. Bioinformatics analysis, qRT-PCR, Western blot and luciferase reporter analysis were performed to validate the relationship between miR-143-3p and its potential targets. We found that miR-143-3p was substantially downregulated in human NSCC tissues and cell line. Forced upregulation of miR-143-3p significantly attenuated cell proliferation and migration. Furthermore, this change could induce apoptosis and G1-phase arrest of NSCC cells. Mechanistically, miR-143-3p directly targeted and significantly suppressed Bcl-2 and IGF1R expression. In summary, miR-143-3p regulation of the proliferation, apoptosis, cell cycle and migration of NSCC probably partly depends on inhibition of Bcl-2 and IGF1R, indicating that miR-143-3p may be a novel molecular therapeutic target for NSCC.
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Affiliation(s)
- Yi Qian
- Department of Family Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yaoshu Teng
- Department of Otorhinolaryngology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Otorhinolaryngology, Affiliated Hangzhou First People's Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
| | - Yuandong Li
- Department of Otorhinolaryngology, Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Xiaojiang Lin
- Department of Otorhinolaryngology, Kaihua People's Hospital, Quzhou, Zhejiang, China
| | - Ming Guan
- Department of Otorhinolaryngology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Otorhinolaryngology, Affiliated Hangzhou First People's Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yong Li
- Department of Otorhinolaryngology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Otorhinolaryngology, Affiliated Hangzhou First People's Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xiaolin Cao
- Department of Otorhinolaryngology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Otorhinolaryngology, Affiliated Hangzhou First People's Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yueqiu Gao
- Department of Otorhinolaryngology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Otorhinolaryngology, Affiliated Hangzhou First People's Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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Quan H, Yan L, Zhang H, Zou L, Yuan W, Wang S. Development and validation of a nomogram for prognosis of sinonasal squamous cell carcinoma. Int Forum Allergy Rhinol 2019; 9:1030-1040. [PMID: 31318493 DOI: 10.1002/alr.22354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/19/2019] [Accepted: 04/28/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Sinonasal 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. METHODS From 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. RESULTS Based 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. CONCLUSION We 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.
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Affiliation(s)
- Huatao Quan
- Department of Radiation Oncology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Li Yan
- Department of Radiation Oncology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Haiyan Zhang
- Department of Radiation Oncology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Lifen Zou
- Department of Radiation Oncology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Wei Yuan
- Department of Radiation Oncology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Shengzi Wang
- Department of Radiation Oncology, Eye and ENT Hospital, Fudan University, Shanghai, China
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Biau J, Lapeyre M, Troussier I, Budach W, Giralt J, Grau C, Kazmierska J, Langendijk JA, Ozsahin M, O'Sullivan B, Bourhis J, Grégoire V. Selection of lymph node target volumes for definitive head and neck radiation therapy: a 2019 Update. Radiother Oncol 2019; 134:1-9. [DOI: 10.1016/j.radonc.2019.01.018] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 11/15/2018] [Accepted: 01/13/2019] [Indexed: 10/27/2022]
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15
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De Cecco L, Serafini MS, Facco C, Granata R, Orlandi E, Fallai C, Licitra L, Marchesi E, Perrone F, Pilotti S, Quattrone P, Piazza C, Sessa F, Turri-Zanoni M, Battaglia P, Castelnuovo P, Antognoni P, Canevari S, Bossi P. A functional gene expression analysis in epithelial sinonasal cancer: Biology and clinical relevance behind three histological subtypes. Oral Oncol 2019; 90:94-101. [PMID: 30846184 DOI: 10.1016/j.oraloncology.2019.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/22/2019] [Accepted: 02/02/2019] [Indexed: 02/06/2023]
Abstract
Epithelial sinonasal cancers (SNCs) are rare diseases with overlapping morphological features and a dismal prognosis. We aimed to investigate the expression differences among the histological subtypes for discerning their molecular characteristics. We selected 47 SNCs: (i) 21 nonkeratinizing squamous cell carcinomas (NKSCCs), (ii) 13 sinonasal neuroendocrine cancers (SNECs), and (iii) 13 sinonasal undifferentiated cancers (SNUCs). Gene expression profiling was performed by DASL (cDNA-mediated annealing, selection, extension, and ligation) microarray analysis with internal validation by quantitative RT-PCR (RT-qPCR). Relevant molecular patterns were uncovered by sparse partial-least squares discriminant analysis (sPLS-DA), microenvironment cell type (xCell), CIBERSORT, and gene set enrichment (GSEA) analyses. The first two sPLS-DA components stratified samples by histological subtypes. xCell highlighted increased expression of immune components (CD8+ effector memory cells, in SNUC) and "other cells": keratinocytes and neurons in NKSCC and SNEC, respectively. Pathway enrichment was observed in NKSCC (six gene sets, proliferation related), SNEC (one gene set, pancreatic β-cells), and SNUC (twenty gene sets, some of them immune-system related). Major neuroendocrine involvement was observed in all the SNEC samples. Our high-throughput analysis revealed a good diagnostic ability to differentiate NKSCC, SNEC, and SNUC, but indicated that the neuroendocrine pathway, typical and pathognomonic of SNEC is also present at lower expression levels in the other two histological subtypes. The different and specific profiles may be exploited for elucidating their biology and could help to identify prognostic and therapeutic opportunities.
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Affiliation(s)
- Loris De Cecco
- Integrated Biology Platform, Department of Applied Research and Technology Development, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
| | - Mara Serena Serafini
- Integrated Biology Platform, Department of Applied Research and Technology Development, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
| | - Carla Facco
- Department of Pathology, University of Insubria and ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Roberta Granata
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Ester Orlandi
- Radiation Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Carlo Fallai
- Radiation Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Lisa Licitra
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy; University of Milan, Italy
| | - Edoardo Marchesi
- Integrated Biology Platform, Department of Applied Research and Technology Development, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
| | - Federica Perrone
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Silvana Pilotti
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Pasquale Quattrone
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Cesare Piazza
- Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, University of Milano, Milan, Italy
| | - Fausto Sessa
- Department of Pathology, University of Insubria and ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Mario Turri-Zanoni
- Department of Otorhinolaryngology, University of Insubria and ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Paolo Battaglia
- Department of Otorhinolaryngology, University of Insubria and ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Paolo Castelnuovo
- Department of Otorhinolaryngology, University of Insubria and ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Paolo Antognoni
- Department of Radiotherapy, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Silvana Canevari
- Integrated Biology Platform, Department of Applied Research and Technology Development, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
| | - Paolo Bossi
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.
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Jain S, Li Y, Kuan EC, Tajudeen BA, Batra PS. Prognostic Factors in Paranasal Sinus Squamous Cell Carcinoma and Adenocarcinoma: A SEER Database Analysis. J Neurol Surg B Skull Base 2018; 80:258-263. [PMID: 31143568 DOI: 10.1055/s-0038-1669420] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 07/07/2018] [Indexed: 12/12/2022] Open
Abstract
Background Outcome studies on sinonasal malignancy are limited to retrospective case series, often with inclusion of diverse histology and short follow-up. The objective of this study was to identify key predictive variables that independently impact survival for paranasal sinus squamous cell carcinoma (SCC) and adenocarcinoma (AC) and to compare these variables in the context of these two distinct clinicopathologic entities. Methods: Analysis was conducted using the Surveillance, Epidemiology, and End Results database from 1973 to 2012 to identify key variables that impact survival for SCC and AC. Results A total of 3,714 cases were included. There were 2,895 SCC cases and 819 AC cases. The mean age at diagnosis was 64.1 years. The male to female ratio for SCC and AC was 1.85 and 1.04, respectively. Patients with SCC and AC were most often diagnosed with stage IV disease in 61.8 and 63.4% of cases, respectively. The majority of patients received combined surgery and radiation (52% for SCC and 43.1% for AC). For SCC, increased age ( p < 0.001) and stage ( p < 0.001) were negative predictors, and surgery improved survival ( p < 0.001) on multivariate analysis. For AC, prognostic factors associated with worse survival include increased age ( p < 0.001) and grade ( p < 0.001) on multivariate analysis. Overall survival was significantly higher in AC compared with SCC at 5 years ( p = 0.001). Conclusion SCC and AC of the paranasal sinuses are both aggressive malignancies with poor survival. For both histological subtypes, increased age predicts worse survival and grade also closely links to survival in AC. These data have important potential implications for treatment planning and pretreatment counseling.
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Affiliation(s)
- Sumit Jain
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, Illinois, United States
| | - Yan Li
- Department of Otolaryngology, Rush University, Chicago, Illinois, United States
| | - Edward C Kuan
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Bobby A Tajudeen
- Department of Otorhinolaryngology - Head and Neck Surgery, Center for Skull Base and Pituitary Surgery, Rush University Medical Center, Chicago, Illinois, United States
| | - Pete S Batra
- Department of Otorhinolaryngology - Head and Neck Surgery, Center for Skull Base and Pituitary Surgery, Rush University Medical Center, Chicago, Illinois, United States
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17
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Janik S, Gramberger M, Kadletz L, Pammer J, Grasl MC, Erovic BM. Impact of anatomic origin of primary squamous cell carcinomas of the nasal cavity and ethmoidal sinus on clinical outcome. Eur Arch Otorhinolaryngol 2018; 275:2363-2371. [PMID: 30027439 PMCID: PMC6096568 DOI: 10.1007/s00405-018-5068-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 07/16/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE Since 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. METHODS We 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). RESULTS Of 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). CONCLUSION Anatomic 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.
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Affiliation(s)
- Stefan Janik
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Vienna, Vienna, Austria
| | - Mariel Gramberger
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Vienna, Vienna, Austria
| | - Lorenz Kadletz
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Vienna, Vienna, Austria
| | - Johannes Pammer
- Clinical Institute of Pathology, Medical University Vienna, Vienna, Austria
| | - Matthaeus Ch Grasl
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Vienna, Vienna, Austria
| | - Boban M Erovic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Vienna, Vienna, Austria. .,Institute of Head and Neck Diseases, Evangelical Hospital Vienna, Hans-Sachs Gasse 10-12, 1180, Vienna, Austria.
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18
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Peck BW, Van Abel KM, Moore EJ, Price DL. Rates and Locations of Regional Metastases in Sinonasal Malignancies: The Mayo Clinic Experience. J Neurol Surg B Skull Base 2017; 79:282-288. [PMID: 29765826 DOI: 10.1055/s-0037-1607288] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 09/04/2017] [Indexed: 12/15/2022] Open
Abstract
Objectives The objective of this study was to identify factors that may influence the rate and location of regional metastasis in sinonasal malignancies (SNMs). Design This is a retrospective review. Setting This study was set at the single-institution tertiary referral center. Participants A total of 299 patients were treated for SNMs from 1994 to 2014. Main Outcome Measures The main outcome measures were incidence and distribution of regional metastases. Results Several histologic subtypes were treated, with squamous cell carcinoma (28.4%), esthesioneuroblastoma (18.1%), and mucosal melanoma (12.4%) being the most common. Of the 299 patients, 59 (19.7%) developed a regional metastasis, either at presentation or during follow-up. Higher cumulative incidence of regional metastases was significantly associated with histologic type ( p ≤0.001) and invasion of the dura ( p = 0.005), infratemporal fossa ( p = 0.036), orbit ( p = 0.020), or palate ( p = 0.016). Ipsilateral level II lymph nodes were the most commonly involved nodes. Contralateral regional metastases were associated with higher risk histologic types ( p = 0.005) and dural invasion ( p = 0.008). Parotid metastases were associated with invasion of the facial soft tissue ( p = 0.028), and retropharyngeal metastases were associated with invasion of the pterygoid plates and musculature ( p = 0.030). Conclusion Histologic type of SNM appears to be the most important factor in predicting the rate of regional metastases. Histologic type and invasion of certain neighboring structures may help define which lymphatic basins are at highest risk for metastasis.
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Affiliation(s)
- Brandon W Peck
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, United States
| | - Kathryn M Van Abel
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, United States
| | - Eric J Moore
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, United States
| | - Daniel L Price
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, United States
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Unsal AA, Kılıç S, Dubal PM, Baredes S, Eloy JA. A population-based comparison of European and North American sinonasal cancer survival. Auris Nasus Larynx 2017; 45:815-824. [PMID: 29056464 DOI: 10.1016/j.anl.2017.09.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/25/2017] [Accepted: 09/13/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Sinonasal cancers (SNC) are rare, thus limiting previous prognostic studies on a multinational level. The aim of this study is to utilize two population-based datasets to compare prognoses for SNC between the United States (US) and Europe. METHODS The European Cancer Registry (EUROCARE) database and the United States National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database were searched to identify survival of patients diagnosed with SNC between 1990 and 2007. Relative survival (RS) data were stratified by age group, gender, geographic location, and diagnostic time period. RESULTS 12,541 SNC cases were identified in EUROCARE, while SEER identified 4,312. Males comprised the majority in Europe (62.3%) and the US (58.3%). Most patients were over 55 years in Europe (77.0%) and the US (69.5%). Age over 75 was a statistically significant poor prognostic indicator for 5-year RS in the US (48.2%; 95% CI=[43.9, 52.4]) and Europe (38.5%; [34.7, 42.7]). Female gender imparted a favorable 5-year RS in all regions except in Central Europe. By region, the US had the highest 5-year RS (58.8%; [56.4, 61.1]) and Eastern Europe had the lowest 5-year RS (37.1%; [34.0, 40.6]). The aggregate European 5-year RS was 48.1% [46.4, 49.8]. CONCLUSION SNC in Europe and the US most commonly affects males and individuals over the age of 55 years. Male gender and age over 75 are poor prognostic factors at 5 years. Five-year RS in the US is higher than the 5-year European aggregate RS.
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Affiliation(s)
- Aykut A Unsal
- Department of Otolaryngology & Facial Plastic Surgery, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Suat Kılıç
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
| | - Pariket M Dubal
- Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Soly Baredes
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
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Carey RM, Parasher AK, Workman AD, Yan CH, Glicksman JT, Chen J, Palmer JN, Adappa ND, Newman JG, Brant JA. Disparities in sinonasal squamous cell carcinoma short- and long-term outcomes: Analysis from the national cancer database. Laryngoscope 2017; 128:560-567. [DOI: 10.1002/lary.26804] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/05/2017] [Accepted: 06/26/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Ryan M. Carey
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
| | - Arjun K. Parasher
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
- Leonard Davis Institute of Health Economics; University of Pennsylvania; Philadelphia Pennsylvania U.S.A
| | - Alan D. Workman
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
- Perelman School of Medicine; Philadelphia Pennsylvania U.S.A
| | - Carol H. Yan
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
| | - Jordan T. Glicksman
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
| | - Jinbo Chen
- University of Pennsylvania and the Department of Biostatistics and Epidemiology; Philadelphia Pennsylvania U.S.A
| | - James N. Palmer
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
| | - Nithin D. Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
| | - Jason G. Newman
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
| | - Jason A Brant
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
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Xiao Z, Tang Z, Qiang J, Qian W, Zhong Y, Wang R, Wang J, Wu L, Tang W. Differentiation of olfactory neuroblastomas from nasal squamous cell carcinomas using MR diffusion kurtosis imaging and dynamic contrast-enhanced MRI. J Magn Reson Imaging 2017; 47:354-361. [PMID: 28661554 DOI: 10.1002/jmri.25803] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 06/16/2017] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To evaluate the use of magnetic resonance (MR) diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced MR imaging (DCE-MRI) in the differentiation of olfactory neuroblastomas (ONBs) from squamous cell carcinomas (SCCs). MATERIALS AND METHODS DKI and DCE-MRI were performed in 17 patients with ONBs and 23 patients with SCCs on a 3T MR scanner. Parameters derived from DKI and DCE-MRI were measured and compared between ONBs and SCCs using an independent samples t-test. The sensitivity, specificity, accuracy, positive predictive values (PPV), negative predictive values (NPV), and the area under the receiver operating characteristic (ROC) curve were determined. RESULTS The mean kurtosis (K) value of ONBs was significantly higher than that of SCCs (P < 0.001), and the mean fractional volume in the extravascular extracellular space (Ve ) value of ONBs was lower than that of SCCs (P < 0.001). The ROC curve analyses yielded a cutoff K value of 0.953, with a sensitivity of 94.1%, a specificity of 69.6%, and an accuracy of 80.0%; the cutoff Ve value was 0.493, with a sensitivity of 70.6%, a specificity of 95.7%, and an accuracy of 85.0%. A parallel test with K value >0.953 or Ve value ≤0.493 achieved a sensitivity of 94.1%, a specificity of 100.0%, and an accuracy of 97.5% for differentiating ONBs from SCCs. CONCLUSION The K value of DKI and Ve value of DCE-MRI have potential use in the differentiation of ONBs and SCCs. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:354-361.
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Affiliation(s)
- Zebin Xiao
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, P.R. China
| | - Zuohua Tang
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, P.R. China
| | - Jinwei Qiang
- Department of Radiology, Jinshan Hospital of Shanghai Medical School, Fudan University, Shanghai, P.R. China
| | - Wen Qian
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, P.R. China
| | - Yufeng Zhong
- Department of Radiology, Jinshan Hospital of Shanghai Medical School, Fudan University, Shanghai, P.R. China
| | - Rong Wang
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, P.R. China
| | - Jie Wang
- Department of Radiotherapy, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, P.R. China
| | - Lingjie Wu
- Department of Otolaryngology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, P.R. China
| | - Wenlin Tang
- Siemens Healthcare Ltd, Shanghai, P.R. China
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Unsal AA, Chung SY, Unsal AB, Baredes S, Eloy JA. A Population-Based Analysis of Survival for Sinonasal Rhabdomyosarcoma. Otolaryngol Head Neck Surg 2017; 157:142-149. [PMID: 28397540 DOI: 10.1177/0194599817696292] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives Literature detailing factors affecting survival in sinonasal rhabdomyosarcoma (SNRMS) is limited due to its rarity. We analyze the demographics, potential prognostic factors, overall survival, and treatment efficacy of SNRMS. Study Design and Setting Administrative database study. Methods SNRMS was queried in the SEER database (1973-2013; Surveillance, Epidemiology, and End Results). Data were analyzed for demographic and clinicopathologic trends. Kaplan-Meier model was utilized for assessing survival. Results A total of 286 cases of SNRMS were identified. The median age at diagnosis was 24.5 years, and the mean tumor size was 5.1 cm. Overall 5-, 10-, and 20-year disease-specific survival was 35.1%, 25.4%, and 12.0%, respectively. Regional lymph node involvement was present at diagnosis in more than half of cases (54.3%) and distant metastasis in 32.2% of cases. Alveolar rhabdomyosarcoma (54.9%) and embryonal rhabdomyosarcoma (23.8%) were the primary histologies. Alveolar-type SNRMS was more likely than the embryonal type to metastasize to distant sites (41.7% vs 24.1%), and it possessed poorer 5-year survival (29.2% vs 45.6%). Distant metastasis decreased 5-year survival from 35.1% to 3.8%, whereas lymph node involvement did not significantly affect survival. Patients <10 years old had the highest survival rates. Primary tumor origin by subsite did not significantly affect survival. Smaller tumor sizes and earlier Intergroup Rhabdomyosarcoma Study Group stages were associated with improved outcomes. Surgical therapy had the highest survival rates. Conclusion SNRMS has overall poorer prognosis than all other parameningeal rhabdomyosarcomas studied. Age <10 years, smaller tumor sizes, lack of distant metastasis, localized tumors, earlier Intergroup Rhabdomyosarcoma Study Group stages, and embryonal histology were all associated with improved outcomes.
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Affiliation(s)
- Aykut A Unsal
- 1 Department of Otolaryngology and Facial Plastic Surgery, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Sei Yeon Chung
- 2 Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Aylin B Unsal
- 2 Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Soly Baredes
- 2 Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- 3 Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jean Anderson Eloy
- 2 Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- 3 Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- 4 Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- 5 Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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Population-Based Results in the Management of Sinonasal and Ventral Skull Base Malignancies. Otolaryngol Clin North Am 2017; 50:481-497. [DOI: 10.1016/j.otc.2016.12.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Svider PF, Setzen M, Baredes S, Liu JK, Eloy JA. Overview of Sinonasal and Ventral Skull Base Malignancy Management. Otolaryngol Clin North Am 2017; 50:205-219. [DOI: 10.1016/j.otc.2016.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Wang X, Lv W, Qi F, Gao Z, Yang H, Wang W, Gao Y. Clinical effects of p53 overexpression in squamous cell carcinoma of the sinonasal tract: A systematic meta-analysis with PRISMA guidelines. Medicine (Baltimore) 2017; 96:e6424. [PMID: 28328848 PMCID: PMC5371485 DOI: 10.1097/md.0000000000006424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The level of p53 protein expression in sinonasal squamous cell carcinoma (SNSCC) has been estimated, but the results remain inconsistent and the point of consensus has not been reached. This study was first determined to evaluate the clinical effects of p53 expression in SCC of the sinonasal tract. METHODS According to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement criteria, the potential literature was searched from diverse databases. The pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated to assess the strength of association between p53 expression and SNSCC. RESULTS Final 17 eligible studies were included in a total of 258 cases and 748 controls. The result of p53 expression was shown to be notably higher in SNSCC than in benign sinonasal papillomas and normal sinonasal mucosa (OR = 26.93, P < 0.001; OR = 39.79, P < 0.001; respectively). Subgroup analyses of ethnicity revealed that p53 expression had significant association with SNSCC in Asian and Caucasian populations in cancer versus benign sinonasal papillomas or normal sinonasal mucosa. The expression of p53 was notably higher in moderately or poorly differentiated SNSCC than in well-differentiated SNSCC (OR = 3.51, P = 0.021), while p53 expression was not associated with histological type. CONCLUSION The results suggested that p53 overexpression may be correlated with the carcinogenesis and progression of SNSCC. The p53 gene may become a novel drug target of SNSCC. Additional studies on the correlation of p53 expression with clinicopathological features are needed.
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Ghosh R, Dubal PM, Chin OY, Patel TD, Echanique KA, Baredes S, Liu JK, Eloy JA. Sphenoid sinus malignancies: a population-based comprehensive analysis. Int Forum Allergy Rhinol 2016; 6:752-9. [PMID: 26891865 DOI: 10.1002/alr.21733] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 12/18/2015] [Accepted: 01/01/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sinonasal malignancies are rare, representing less than 1% of all cancers, with the sphenoid sinus accounting for 1% to 2% of these cases. Sphenoid sinus malignancies exhibit very poor outcomes. There is a paucity of literature describing their histopathological features, incidence trends, treatment, and survival. We seek to elucidate these factors using a national population-based resource. METHODS The Surveillance, Epidemiology, and End Results (SEER) database was used to identify malignant sphenoid sinus tumors. The results were analyzed for demographics, incidence, and clinicopathologic trends. Survival was calculated using Kaplan-Meier analysis. RESULTS The search identified 472 cases. The mean and median age at diagnosis was 60.0 years. Males represented 54.9% of cases. By race/ethnicity, 82.4% were white and 8.5% were black. The four most common histopathologies were squamous cell neoplasms (29.4%), adenocarcinomas (14.4%), non-Hodgkin's mature B-cell lymphomas (13.1%), and unspecified epithelial neoplasms (11.0%). The overall incidence from 2000 to 2012 was 0.030 per 100,000. Kaplan-Meier analysis demonstrated an overall 5-year disease-specific survival (DSS) of 48.1%. Of the most common histopathological subtypes, 5-year DSS was best for mature B-cell NHL (64.0%) and worst for unspecified epithelial neoplasms (25.6%). CONCLUSION Sphenoid sinus malignancies are rare, with high prevalence in white males. The most common histopathology is squamous cell neoplasms. They exhibit significant locoregional extension. Of the common sphenoid sinus malignant subtypes, 5-year DSS is best for mature B-cell NHL and worst for unspecified epithelial neoplasms.
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Affiliation(s)
- Ritam Ghosh
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
| | - Pariket M Dubal
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
| | - Oliver Y Chin
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
| | - Tapan D Patel
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
| | - Kristen A Echanique
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ
| | - James K Liu
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ
- Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ
- Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ
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