Clinical management of localized undifferentiated sinonasal carcinoma

Perri, Francesco; Scarpati, Giuseppina Della Vittoria; Ionna, Franco; Longo, Francesco; Montano, Massimo; Muto, Paolo; Ravo, Vincenzo; Giuliano, Mario; Caponigro, Francesco

doi:10.1097/cad.0000000000000707

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…However, trimodal treatment regimens, including surgery, radiotherapy, and chemotherapy are associated with improved outcome compared to bimodal approaches. 13,14 Moreover, due to the complex anatomical location of these tumors and the advanced tumor stages 14 in the majority of cases at time of diagnosis, surgical treatment concepts often requiring combined endoscopic and open craniofacial approaches, have mainly focused on radical tumor resection with clear resection margins and good local control. Consequently, the issue of elective neck treatment, and of elective neck dissection (END) in particular, has been usually neglected and not been addressed in initial therapy.…”

Section: Introductionmentioning

confidence: 99%

Elective neck treatment in sinonasal undifferentiated carcinoma: Systematic review and meta‐analysis

Faisal¹,

Seemann²,

Lill³

et al. 2020

Head & Neck

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Sinonasal undifferentiated carcinomas (SNUCs), being an aggressive malignancy with dismal survival outcome, have given limited consideration regarding management of regional failures. A total of 12 studies, published between 1999 and 2019, met inclusion criteria. We performed a meta-analysis assessing regional (neck) relapse after elective neck treatment compared to observation in clinically node negative (N0) necks. Clinical data of 255 patients were used for meta-analysis. Among them, 83.4% of patients presented with T4 tumors and 14.1% had positive neck nodes. Elective neck treatment was applied in 49.5% of analyzed patients. Regional relapses occurred in 3.7% of patients who have undergone elective neck treatment compared to 26.4% in patients who had not. Elective neck treatment significantly reduced the risk of regional recurrence (odds ratio 0.20; 95% confidence interval 0.08-0.49; P = .0004). The meta-analysis indicates that elective neck treatment could significantly reduce the risk of regional failures in patients with SNUCs. K E Y W O R D Selective neck dissection, elective neck treatment, regional relapse, sinonasal undifferentiated carcinoma, SNUC

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Section: Introductionmentioning

confidence: 99%

Elective neck treatment in sinonasal undifferentiated carcinoma: Systematic review and meta‐analysis

Faisal¹,

Seemann²,

Lill³

et al. 2020

Head & Neck

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“…Sinonasal undifferentiated carcinoma (SNUC) is a rare, highly aggressive epithelial malignancy that is often locally advanced at presentation. Multimodality treatment is standard, 1 2 3 4 5 and the role of primary surgery is limited by the extent of intracranial extension. In selected patients, the response of SNUC to induction chemotherapy (IC) can be used to guide subsequent therapy.…”

Section: Introductionmentioning

confidence: 99%

Sinonasal Undifferentiated Carcinoma with Failed Response to Induction Chemotherapy

et al. 2022

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Sinonasal undifferentiated carcinoma (SNUC) is a rapidly growing malignancy with a propensity for extensive local invasion. Multimodal therapy, including surgery, radiotherapy, and chemotherapy is the standard approach to treatment, but the optimal sequence and combination of these modalities is uncertain. Induction chemotherapy is being increasingly utilized based on recent reports that show better outcomes for patients who respond to chemotherapy and the ability to determine further course of treatment. We present a unique case of a patient with locally advanced SNUC that did not respond to induction chemotherapy and a review of the available literature relating to management of this rare malignancy.

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“…After an initial title and abstract screen, 640 articles were excluded. Full text manuscript review and application of inclusion criteria excluded 38 articles, yielding 17 studies for individual patient data analysis 5,8,12,20,[25][26][27][28][29][30][31][32][33][34][35][36][37]. 3.1 | Individual patient data meta-analysis…”

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confidence: 99%

Meta‐analysis of multi‐modality therapies in sinonasal undifferentiated carcinoma—A timely update

See,

Chu,

Lim

et al. 2023

Clinical Otolaryngology

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ObjectivesSinonasal undifferentiated carcinoma (SNUC) is a rare but aggressive tumour with very poor prognosis. There are currently no well‐established clinical trials to guide therapy and the impact of various treatment modalities on survival is not well defined. We aim to provide an updated systematic review on current treatment modalities on survival outcomes.Design and SettingIndividual patient data were extracted, and survival data pooled in a one‐stage meta‐analysis. Descriptive statistics were analysed using the Kaplan–Meier method. Patient‐level comparisons stratified by treatment modalities, adjusted for demographics, were conducted using shared‐frailty Cox regression.Participants and Main outcome measuresParticipants include all patients diagnosed with SNUC based on histological evidence. We looked at the overall cumulative survival outcome for different treatment modalities and overall survival by treatment modality in low versus high stage SNUC patients.Results and ConclusionSeventeen studies were identified, comprising 208 patients from 1993 to 2020. There was no significant difference in cumulative overall survival in low versus high stage patients, and no significant difference in outcomes by treatment modality. The overall cumulative survival of SNUC is 30% at 95 months. Among patients treated with various combinations of treatment modalities, patients with chemoradiotherapy had the highest cumulative survival of 42% at 40 months. Definitive chemoradiotherapy was associated with improved disease survival rate. Regardless of tumour stage, patients should be treated early and aggressively, with no superiority of one treatment regimen over another. Trimodality treatment does not confer survival advantage over bimodality treatment.

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Clinical management of localized undifferentiated sinonasal carcinoma

Cited by 5 publications

References 26 publications

Elective neck treatment in sinonasal undifferentiated carcinoma: Systematic review and meta‐analysis

Elective neck treatment in sinonasal undifferentiated carcinoma: Systematic review and meta‐analysis

Sinonasal Undifferentiated Carcinoma with Failed Response to Induction Chemotherapy

Meta‐analysis of multi‐modality therapies in sinonasal undifferentiated carcinoma—A timely update

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