N/A. Laryngoscope, 2016 127:430-439, 2017.

4. Laryngoscope, 126:560-565, 2016.

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.

This study represents the largest cohort of SNACC patients to date. Factors that confer a survival benefit in SNACC include M0 disease, and presentation primarily in the nasal cavity. Overall low rates of nodal metastasis may not warrant the use of elective neck dissections, unless there is clinical suspicion. Modalities of therapy that include surgery greatly improve survival. Adjuvant radiotherapy appears to slightly improve 5-year disease-free survival but does not impact long-term survival.

Objectives/Hypothesis: The role of cumulative ultraviolet (UV) radiation in cutaneous squamous cell carcinoma of the lip (CSCCL) is well understood. This study seeks to evaluate overall survival as well as incidence and demographics across geographic regions, given differences in UV exposure across the United States.Study Design: Retrospective population-based analysis.Methods: A total of 14,901 CSCCL cases were identified as being from the West, Midwest, South, or Northeast, utilizing the Surveillance, Epidemiology, and End Results registry from 1973 to 2013. Demographics, stage of disease, and treatment modalities were compared among regions.Results: Of the CSCCL cases reported, 58.3%, 24.5%, 10.8%, and 6.4% originated from the West, Midwest, South, and Northeast, respectively. Patients most commonly presented with T1 tumors (81.3%), and nodal and distant metastasis was rare for patients from all regions (3.1% and 0.3%, respectively). Patients with American Joint Committee on Cancer stage II and higher were most likely from the Northeast or South. Overall, most patients were treated with surgery monotherapy (89.5%); however, surgical monotherapy was least commonly utilized in patients in the Northeast and South. Overall 5-year disease specific survival was measured at 94.7%.Conclusion: Although areas of high UV index are implicated in increased morbidity and mortality due to CSCCL, this study indicates that a variety of factors play a role in CSCCL incidence and outcomes in the United States. The elderly and non-white populations were identified as poor prognostic demographic factors. Investigation detailing differences in CSCCL detection and treatment may aid in the identification of higher-risk populations.Key Words: Cutaneous squamous cell carcinoma of the lip, head and neck cancer, lip cancer, SEER, surveillance epidemiology and end results, population-based, survival, cutaneous head and neck cancer.