Current status of sinonasal cancer survivorship care

Abstract

Sinonasal cancer is a heterogeneous orphan disease of diverse histologies, each with distinct clinical, oncologic, and toxicity profiles. Because of the comparative rarity of these cancers, sinonasal cancers are treated as a grouped diagnosis despite their clinical and biological heterogeneity. Multimodality treatment with a combination of surgery, chemotherapy, and/or radiotherapy is the standard‐of‐care for advanced‐stage patients but there are few surveillance or follow‐up practice guidelines or formalized survivorship care pathways. A scoping literature review was conducted via PubMed, EMBASE, and Google Scholar. A total of 112 studies were included, which were grouped along the following topics: surveillance, second primary tumors, quality of life, and symptom burden. Sinonasal cancer tends to exhibit a higher rate of local failure and occur in a delayed fashion compared to mucosal malignancies of the head and neck. Moreover, the site of failure and time‐varying risk of recurrence is histology‐specific. Following multimodality treatment of the skull base, patients may experience endocrine, visual, auditory, sinonasal, olfactory, and neurocognitive deficits, as well as psychosocial impairments that impact multiple physical and neuropsychological domains, resulting in diminished quality of life. Sinonasal cancer patients would benefit from tailored, histology‐specific survivorship programs to address the recurrence, second primary, and functional impairments resulting from disease and treatment toxicity.

Algorithms of follow-up in patients with head and neck cancer in relation to primary location and advancement. Consensus of Polish ENT Society Board and Head Neck Experts

“…Sinonasal cancer tends to exhibit a higher rate of local failure and occur in a delayed fashion compared with mucosal HNC. Moreover, the site of failure and time-varying risk of recurrence is histology-specific ( 79 ). Endoscopy has low sensitivity in recurrence detection, especially in the asymptomatic patient; CT, MRI (Khalili), and PET/CT (Ozturk) are useful although prolonged inflammation can lead to a high number of false positives ( 77 ).…”

“…Following multimodality treatment of the skull base, patients may experience endocrine, visual, auditory, sinonasal, olfactory, and neurocognitive deficits, resulting in poor QoL. Thus, patients with sinonasal cancer would benefit from tailored survivorship programs to address not only the recurrence but also functional impairments resulting from disease and treatment toxicity ( 79 ). Regardless of the type of imaging, symptomatic presentation after treatment had a specificity of 91.0%, and the frequency of scans was not associated with the risk of recurrence.…”