Elective neck dissection for T3/T4 cN0 sinonasal squamous cell carcinoma

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Cancer

Background:

• Management of clinically node-negative (cN0) necks in locally advanced sinonasal squamous cell carcinoma (SNSCC) is inconsistent.
• Elective neck dissection (END) for cN0 necks in SNSCC is a debated surgical approach.

Purpose of the Study:

• To evaluate the impact of elective neck dissection (END) on overall survival (OS) in patients with locally advanced sinonasal squamous cell carcinoma (SNSCC).
• To identify factors associated with the decision to perform END in this patient population.

Main Methods:

• Retrospective analysis of T3/T4 cN0 M0 SNSCC patients treated surgically, identified from the National Cancer Database (NCDB).
• Propensity score-matched analysis to compare overall survival (OS) between patients who underwent END and those who did not.
• Logistic regression was used to assess factors influencing the choice of END.

Main Results:

• Of 220 patients (19.6%), 220 underwent END. Elective neck dissection (END) did not significantly correlate with improved overall survival (OS) in propensity score-matched cohorts.
• No significant survival benefit was observed in subgroups, including maxillary sinus tumors or by radiation status.
• The rate of occult metastasis detected via END was 12.7%.

Conclusions:

• Elective neck dissection (END) did not demonstrate a significant improvement in overall survival (OS) for locally advanced sinonasal squamous cell carcinoma (SNSCC) in this study.
• Further investigation into disease-free survival is crucial to fully determine the role and benefit of END in advanced-stage SNSCC.