Abstract
BackgroundThe sinuses, nasal cavity, and middle ear represent a rarer location of head and neck malignancy than more common sites such as the larynx and oral cavity. Population-based studies are a useful tool to study the demographic and treatment factors affecting survival in these malignancies.MethodsPopulation-based database search of the Survival, Epidemiology, and End Results (SEER) database from 1973 to 2015 for malignancies involving the nasal cavity, paranasal sinuses, and middle ear. Data were analyzed for demographics, treatment type, stage, primary site and histopathologic type. Kaplan-Meier analysis was used to assess and compare survival.ResultsA total of 13,992 cases of sinonasal or middle ear malignancy were identified and analyzed. The majority of patients were between ages 50 and 80 at the time of diagnosis. Overall 5-, 10-, and 20-year survival was 45.7%, 32.2%, and 16.4%, respectively. Lymph node metastasis was reported in 4.4% of patients, while distant metastasis was present in 1.5% of cases. On univariate analysis surgical vs. nonsurgical treatment, sex, race, age at diagnosis, T stage, N stage, M stage, AJCC overall stage, primary site, tumor grade, and histopathologic subtype significantly affected survival. On multivariate analysis age, race, sex, primary site, overall AJCC stage, surgical vs. nonsurgical treatment, and T, N, and M stage remained significant predictors of overall survival.ConclusionsMalignancies of the nasal cavity, paranasal sinuses, and middle ear account for a minority of overall head and neck cancers. The overall 5-, 10-, and 20-year survival for these malignancies is relatively low. Higher T, N, M, and overall stage and higher tumor grade is associated with lower survival. Patients treated with surgery as part of the treatment regimen had higher overall survival. Demographics and primary site also significantly affect survival. Certain histopathologic subtypes were associated with poorer survival.
Highlights
The sinuses, nasal cavity, and middle ear represent a rarer location of head and neck malignancy than more common sites such as the larynx and oral cavity
Given the relative rarity of nasal cavity, sinus, and middle ear malignancies, this study aimed to update the population-based literature and to report the demographics, effects of treatment modality, and survival outcomes of patients treated for nasal cavity, paranasal
SEER data was analyzed for overall survival, patient age, sex, and race, and overall AJCC (American Joint Committee on Cancer), tumor (T), nodal (N), and distant metastasis (M) stage, surgical treatment, histopathological type, and primary tumor site
Summary
The sinuses, nasal cavity, and middle ear represent a rarer location of head and neck malignancy than more common sites such as the larynx and oral cavity. Symptoms in patients with sinonasal or middle ear cancer may be relatively innocuous, gradual in onset, and may mimic other more benign conditions, and these cancers may be discovered at a later stage relative to oral or laryngeal cancers. These factors and the relative proximity to important anterior and lateral skull base structures and neural and vascular structures may make surgical treatment more difficult, and these tumors tend to have a relatively poor survival rate. Given the relative rarity of nasal cavity, sinus, and middle ear malignancies, this study aimed to update the population-based literature and to report the demographics, effects of treatment modality, and survival outcomes of patients treated for nasal cavity, paranasal
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