Regional Recurrence of Squamous Cell Carcinoma of the Nasal Cavity

Abstract

To demonstrate whether the regional recurrence (RR) of squamous cell carcinoma (SCC) of the nasal cavity is higher than previously suspected. Data Sources: Original articles, including a previously published series from our institution, were identified from systematic searches of the MEDLINE database. Study Selection: Studies that analyzed tumors other than SCC or tumors from sites other than the nasal cavity were excluded. Studies that did not report an RR were also excluded. Data Extraction: Studies identified by the literature search were reviewed by a single reviewer (W.C.S.), and studies not excluded were reviewed for data extraction by 2 reviewers (W.C.S. and M.Y.C.). Data Synthesis: From the 23 studies reviewed, the average weighted percentage RR for SCC of the nasal cavity was 18.1% (95% confidence interval, 13.4%-22.8%). Conclusions: Currently, few authors advocate elective treatment of the neck in patients with high-risk SCC of the nasal cavity. The results of this systematic review and meta-analysis demonstrate that the RR of this entity may be higher than previously suspected. Because many studies included other histopathologies or analyzed recurrence data from tumors of multiple subsites, a true RR for SCC of the nasal cavity has not been firmly established. Now that a uniform staging system exists for nasal cavity cancers, better prospective analysis of these tumors will be available. The authors suggest that the risk of RR of certain high-risk SCCs of the nasal cavity to the lymph nodes, including the perifacial and upper cervical lymphatics, may approach the frequently cited 20% risk suggestive of consideration for elective regional therapy.

Impact of anatomic origin of primary squamous cell carcinomas of the nasal cavity and ethmoidal sinus on clinical outcome

“…Five-year disease specific survival (DSS) ranges from 50 to 80% [6–11]. Nodal involvement, advanced tumor stage and larger tumor size are worse prognostic factors for outcome [1, 2].…”

“…Nodal involvement, advanced tumor stage and larger tumor size are worse prognostic factors for outcome [1, 2]. Nodal involvement represents a strong worse prognostic factor that results in almost a halving of survival [6–11]. A recently published meta-analysis among 1283 patients with sinonasal carcinomas revealed that elective neck treatment could reduce the risk of regional recurrence [2].…”

“…First results indicate that HPV positivity seems to represent a favorable prognostic factor for survival [12, 13], while histologic grade does not [11]. …”

“…Moreover, the impact of human papilloma virus (HPV) infection on outcome in nasal SCCs has been evaluated. First results indicate that HPV positivity seems to represent a favorable prognostic factor for survival [ 12 , 13 ], while histologic grade does not [ 11 ].…”

Das Plattenepithelkarzinom des Naseneingangs – Eine Literaturübersicht

“…Scurry et al [53] publizierten eine Metaanalyse und wiesen auf eine hohe Rezidivrate bei dieser Tumorentität hin. McCollough et al [7] fanden in 25 % der T4-Tumoren (AJCC) regionale Lymphknotenmetastasen und sprechen sich daher für eine elektive regionale Bestrahlung in dieser Subgruppe aus.…”