Abstract
PurposeSinonasal 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.MethodsA 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.ResultsTwo-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).ConclusionThe 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.
Highlights
Sinonasal malignancies (SNM) represent a rare and complex group of cancers that characteristically includes a wide range of histopathological subtypes [1]
This study describes characteristics and fate for 226 consecutive patients with de novo SNM, including sinonasal mucosal melanoma (SNMM) and ENB, who were treated at a single tertiary academic referral centre
Together with published literature on the matter, our results may provide a background for future randomized controlled trials (RCTs)
Summary
Sinonasal malignancies (SNM) represent a rare and complex group of cancers that characteristically includes a wide range of histopathological subtypes [1]. The treatment comprises surgery and radiotherapy (RT) with or without. The three Nordic studies by Thorup et al, Koivunen et al, and Filtenborg et al utilize population‐based cancer registries and aim to identify and study all cases in a defined population [4,5,6]. The principal drawback of such studies is a lack of detailed information, which can only be obtained by analysing patient records. As indicated by Filtenborg et al, the case detection rate may vary, e.g., as reflected by an 8% discrepancy between the Danish Cancer
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