Sinonasal cancer: Analysis of oncological failures in 156 consecutive cases

Mirghani, Haïtham; Mortuaire, G.; Armas, Gian Luca; Hartl, Dana M.; Aupérin, Anne; Bedoui, Sophie El; Chevalier, Dominique; Lefèbvre, Jean Louis

doi:10.1002/hed.23356

Cited by 37 publications

(63 citation statements)

References 27 publications

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“…Again, due to the rarity of the disease, scant information exists about recurrent and/or metastatic (RM) sinonasal epithelial cancers (SCs) . In addition, in this setting the choice of treatment is tailored on the single‐patient global performance status and disease characteristics as well as tumor histology .…”

Section: Introductionsupporting

confidence: 87%

Locally advanced epithelial sinonasal tumors: The impact of multimodal approach

et al. 2019

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Objective Outcomes of locally advanced epithelial sinonasal cancers remain unsatisfactory; moreover, only limited and heterogeneous data exist on prognostic factors. Methods We reviewed all consecutive patients with American Joint Committee Cancer stage III to IV epithelial sinonasal cancers treated with platinum‐based induction chemotherapy (IC) followed by locoregional treatment between 1996 and 2015. Results We identified 69 patients treated with a multimodal approach (IC, surgery, radiotherapy). Overall, 44 patients recurred (64%). Of those, 19 patients received salvage surgery, but only four remained disease‐free. Median overall survival (OS) was 62.5 months. Sinonasal neuroendocrine and small cell histotypes (P = 0.0085), neuroendocrine differentiation (P = 0.006), and lack of response to IC (P = 0.03) were associated with worse OS. In patients who recurred, median OS was 13 months since recurrence. Survival was longer in patients submitted to salvage surgery (44%) than in those receiving chemotherapy alone at recurrence (29.5 vs. 4.6 months). Patients with a clinical benefit after palliative chemotherapy had a longer median OS than those with disease progression (29.2 vs. 4.4 months; P < 0.0001). Conclusion Globally, the prognosis of locally advanced epithelial sinonasal cancers is dismal, with worse outcomes for neuroendocrine lesions. In the recurrent setting, feasibility of salvage surgery and clinical benefit from palliative chemotherapy are associated with longer OS. A multimodal treatment strategy with IC seems to offer improved OS when compared with other retrospective series not employing such a therapeutic tool. Level of Evidence 4 Laryngoscope, 130:857–865, 2020

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Section: Introductionsupporting

confidence: 87%

Locally advanced epithelial sinonasal tumors: The impact of multimodal approach

et al. 2019

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“…Nodal failure was less often, occurring in 8-33% of all failures. Isolated nodal failure was observed in 4.8% 24 – 7.3% 17 of all patients when the primary site was controlled. Isolated neck failure accounted for 38-82% of all the cervical failures.…”

Section: Elective Management Of the Neck In Maxillary Cancermentioning

confidence: 95%

Management of the neck in maxillary sinus carcinomas

Dooley

Shah²

2015

Current Opinion in Otolaryngology & Head and Neck Surgery

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Purpose of Review To discuss and review the role for elective treatment of the neck in maxillary squamous cell carcinoma. Improvements in survival have been seen due to improved local therapies and control, therefore the treatment of the neck has become a topic of debate. Recent findings The risk of occult metastases in neck nodes is higher for T 3-4 tumors. The rate of nodal relapse in the N0 neck without elective treatment is 8-15%. With elective irradiation the nodal relapse rate decreases. However, most nodal relapses are accompanied by local failure or distant disease. Local failure remains the most common site of failure and cause of death in this patient population. Summary Treatment failure occurs overall in 62% of all patients, with local recurrence by far the most common site of treatment failure which is rarely amenable to salvage therapy. Therefore elective neck irradiation is not routinely indicated in the clinically N0 neck; those who recur only in the neck can be surgically salvaged more than 50% of the time.

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“…Sacrifice of these structures can cause esthetic and functional problems, both of which can directly impact patient quality-of-life [2,4,5,13]. CCRT is an accepted treatment for locally advanced SCC of the head and neck, with the aim of preserving the primary tumor site and improving patient survival [6][7][8]14,15]. However, the outcomes of CCRT as a primary treatment for locally advanced sinonasal SCC have not been extensively studied.…”

Section: Discussionmentioning

confidence: 98%

“…In addition, whilst previous reports also analyzed sinonasal malignancy treatment outcomes, they included patients with all stages of malignancy and only a small proportion of patients who underwent chemoradiation. In addition, previous studies did not specifically analyze the results of CCRT for the treatment of sinonasal SCC [1,2,8].…”

Section: Introductionmentioning

confidence: 96%