Prognostic survival value of retropharyngeal lymph node involvement in sinonasal tumors: A retrospective, descriptive, and exploratory study

Gangl, Katharina; Nemec, Stefan F.; Altorjai, Gabriela; Pammer, Johannes; Grasl, Matthäus Ch.; Erovic, Boban M.

doi:10.1002/hed.24782

Cited by 13 publications

(14 citation statements)

References 26 publications

(61 reference statements)

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“…Overall, 173 cases were enrolled in this study, 89 of which were histologically confirmed as IP-SCC and 84 as de novo SCC. Consistent with the findings from recently published retrospective series, 17,18 the current study has also shown that males were affected more than females for both IP-SCC and de novo SCC (2.87:1 and 2.82:1). Tumors in both groups were most frequently located in the maxillary sinus, followed by nasal or ethmoid sinus and frontal or sphenoid sinus.…”

Section: Discussionsupporting

confidence: 92%

Prognostic Factors of Sinonasal Squamous Cell Carcinomas Arising De Novo and From Inverted Papilloma

Wang

Zhang

et al. 2020

Am J Rhinol�Allergy

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Background The prognostic factors and survival difference between inverted papilloma (IP)-associated sinonasal squamous cell carcinoma (SCC) and de novo SCC are unclear. Objective This study aimed to compare the clinical features and oncologic outcomes in patients with IP-associated SCC and de novo SCC; and additionally, to analyze the prognostic factors of the two types of SCCs. Methods Data from 173 SCC patients treated for IP-associated SCC (n = 89) and de novo SCC (n = 84), were reviewed retrospectively for demographic features, tumor characteristics, treatment modality, and clinical outcomes. 5-year overall survival (OS) and disease free survival (DFS) was analyzed using the Kaplan-Meier method, and Cox proportional hazards model was used to analyze factors influencing prognosis. Results A higher proportion of IP-associated SCC occurred in frontal and sphenoid sinus compared to de novo SCC. The two groups demonstrated similar 5-year OS and DFS (5-year OS: 63.3% and 55.4%, DFS: 45.4% and 50.1%, respectively). The metachronous tumor had a relatively better prognosis outcome than synchronous tumor and de novo SCC (5-year OS: 73.1%, 54.5% and 55.4%, respectively). Both groups showed similar loco-regional recurrence rates ( p > 0.05); however, de novo SCC tumors demonstrated an increased incidence of distant metastasis. Multivariate analysis indicated that age >70 years, advanced tumor stage and surgical margin were independent predictive factors for the risk of mortality (HR 2.047, 1.581 and 1.931, respectively). Conclusion IP-associated SCCs have an aggressive loco-regional tendency, whereas de novo SCCs have a higher aggressive distant metastatic propensity. Age, tumor stage and surgical positive margin are key factors for poor prognosis and should be routinely taken into consideration during treatment planning and subsequent surveillance.

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Section: Discussionsupporting

confidence: 92%

Prognostic Factors of Sinonasal Squamous Cell Carcinomas Arising De Novo and From Inverted Papilloma

Wang

Zhang

et al. 2020

Am J Rhinol�Allergy

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“…In this retrospective analysis, the authors found that RPN metastasis was a negative prognosticator for OS. 20 Differently from this study, we did not find any relation between RPN involvement and prognosis, probably because of the small number of patients.…”

Section: Discussioncontrasting

confidence: 89%

“…18 RPNs with at least one of the following characteristics were regarded as pathologic: minimal axial diameter of 6 mm or larger (measured perpendicularly to the course of the internal jugular vein), central necrosis, irregular borders suggesting extracapsular spread, ringed postcontrast enhancement, groups of 2 or more RPNs, and any medial RPN. 19,20 Furthermore, we defined total GTV as the sum of GTV-T, GTV-N, and GTV-RPN while GTV total node (GTV-TN) included only GTV-RPN and GTV-N.…”

Section: Methodsmentioning

confidence: 99%

Prognostic role of primary tumor, nodal neck, and retropharyngeal GTVs for unresectable sinonasal cancers treated with IMRT and chemotherapy

et al. 2019

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Background: We evaluated the prognostic role of gross tumor volumes (GTVs) of primary tumor and positive lymph nodes on overall survival (OS) and progression-free survival (PFS) in locally advanced unresectable sinonasal cancer (SNC) treated with definitive intensity-modulated radiotherapy (IMRT) with or without chemotherapy. Methods: Primary tumor GTV (GTV-T), pathologic neck nodes GTV (GTV-N), and positive retropharyngeal nodes GTV (GTV-RPN) of 34 patients with epithelial nonglandular SNC receiving IMRT with or without chemotherapy were retrospectively measured. The GTV variables were analyzed in relation with OS and PFS. Survival curves were estimated using the Kaplan-Meier method and compared with the log-rank test. We also estimated the crude cumulative incidence of locoregional relapses only. The optimal volume cutoff value was determined using an outcome-oriented method among the observed values. Results: GTV-T was significantly associated with decreased OS ( P=0.003) and PFS ( P=0.003). Moreover, patients with disease total volumes (GTV) smaller than 149.44 cm³ had better OS and PFS than patients with higher volumes ( P<0.0001 for both). Neck nodal metastasis impacted on OS and PFS ( P=0.030 and P=0.033, respectively), but GTV-N did not ( P=0.961; P=0.958). Retropharyngeal nodes metastasis was not associated with prognosis (OS: P=0.400; PFS: P=0.104). When GTV-RPN was added to GTV-N (GTV-TN), a relation with PFS ( P=0.041) and a trend toward significance for OS ( P=0.075) were found. Conclusions: Our results show that tumor volume is a powerful predictor of outcome in SNC. This could be useful to identify patients with worse prognosis deserving different treatment strategies.

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“…Patients with RPLN metastasis had worse OS in line with recent literature 10 and RPLN metastasis was found to be of independent negative prognostic value in multivariable regression analysis. AJCC 8th edition and former editions do not specifically include RPLN in the N staging of sinonasal carcinoma.…”

Section: Discussionsupporting

confidence: 87%

Sinonasal carcinoma and Ohngren's line: Retrospective cohort study of 39 patients

Gangl

Janik

Nemec

et al. 2021

Clinical Otolaryngology

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Prognostic survival value of retropharyngeal lymph node involvement in sinonasal tumors: A retrospective, descriptive, and exploratory study

Abstract: Retropharyngeal lymph node involvement at diagnosis is a significant prognostic factor for decreased OS and locoregional control in sinonasal carcinoma.

Cited by 13 publications

References 26 publications

Prognostic Factors of Sinonasal Squamous Cell Carcinomas Arising De Novo and From Inverted Papilloma

Prognostic Factors of Sinonasal Squamous Cell Carcinomas Arising De Novo and From Inverted Papilloma

Prognostic role of primary tumor, nodal neck, and retropharyngeal GTVs for unresectable sinonasal cancers treated with IMRT and chemotherapy

Sinonasal carcinoma and Ohngren's line: Retrospective cohort study of 39 patients

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