Locally advanced epithelial sinonasal tumors: The impact of multimodal approach

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...

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Published in:The Laryngoscope 2020-04, Vol.130 (4), p.857-865
Main Authors: Orlandi, Ester, Cavalieri, Stefano, Granata, Roberta, Nicolai, Piero, Castelnuovo, Paolo, Piazza, Cesare, Schreiber, Alberto, Turri‐Zanoni, Mario, Quattrone, Pasquale, Miceli, Rosalba, Infante, Gabriele, Sessa, Fausto, Facco, Carla, Calareso, Giuseppina, Iacovelli, Nicola Alessandro, Mattavelli, Davide, Paderno, Alberto, Resteghini, Carlo, Locati, Laura Deborah, Licitra, Lisa, Bossi, Paolo
Format: Article
Language:English
Subjects:
Chemotherapy
Head & neck cancer
induction chemotherapy
Medical prognosis
multimodal treatment
radiation
Sinonasal cancer
Surgery
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Summary: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
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.28202