Related Experiment Video
Updated: Nov 23, 2025
Identification of OTX1 and OTX2 As Two Possible Molecular Markers for Sinonasal Carcinomas and Olfactory Neuroblastomas
Published on: February 28, 2019
Survival outcomes in sinonasal carcinoma with neuroendocrine differentiation: A NCDB analysis
Khalil Issa1, Feras Ackall1, Sin-Ho Jung2
1Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, NC, USA.
Background:
Sinonasal carcinoma with neuroendocrine differentiation (SCND) is a rare group of tumors with poor prognosis. Treatment and sequence of therapies are still unclear. The goal of this study is to analyze treatment outcomes in SCND using a national database.
Methods:
The National Cancer Database was queried for SCND from 2004 to 2014. Patient demographics, tumor characteristics and treatment paradigms were tabulated. Multivariable Cox proportional hazards regression was performed for statistical analysis of treatment regimen on overall survival (OS).
Results:
A total of 415 patients were identified. Most patients were male (61.2%), with a median age of 58 years and the most common primary site was the nasal cavity (52.5%). T4 tumors were observed in 67.7% of cases. Unimodality (41.9%) and bimodality (43.9%) therapies were the most common treatment modalities. Radiation therapy was the only treatment administered in 30% of the patients, while 27.2% received definitive chemoradiation (CRT) and 11.6% had surgery with adjuvant CRT. In our Cox-PH model, age (HR = 1.04, p < 0.001), T4 (HR = 2.6, p = 0.004) and N2/N3 (HR = 2.18, p = 0.001) were associated with worse survival. Trimodality (HR = 0.49, p = 0.005) and bimodality (HR = 0.65, p = 0.009) therapies had a better OS compared to unimodality. Patients treated with definitive CRT or surgery with adjuvant CRT had a significant increase in OS (p = 0.01 and 0.002 respectively).
Conclusion:
SCND appears to be best treated using a multimodality approach with definitive CRT or surgery followed by CRT. Neoadjuvant chemotherapy could be helpful in selecting the best treatment strategy.
Insights
Multimodality therapy, including definitive chemoradiation (CRT) or surgery with adjuvant CRT, improves survival for sinonasal carcinoma with neuroendocrine differentiation (SCND). These findings offer guidance for treating this rare cancer.
Area of Science:
- Oncology
- Head and Neck Surgery
- Radiation Oncology
Background:
- Sinonasal carcinoma with neuroendocrine differentiation (SCND) is rare and has a poor prognosis.
- Optimal treatment strategies for SCND remain unclear.
- This study analyzes treatment outcomes using a national cancer database.
Purpose of the Study:
- To evaluate treatment outcomes in patients with SCND.
- To identify factors influencing overall survival (OS) in SCND.
- To compare the effectiveness of different treatment modalities for SCND.
Main Methods:
- Utilized the National Cancer Database (2004-2014) for SCND cases.
- Collected data on patient demographics, tumor characteristics, and treatment regimens.
- Performed multivariable Cox proportional hazards regression to analyze OS.
Main Results:
- Analyzed 415 SCND cases; most patients were male with advanced T4 tumors.
- Multimodality therapies (bimodality and trimodality) were associated with better OS compared to unimodality.
- Definitive chemoradiation (CRT) or surgery with adjuvant CRT significantly increased OS.
Conclusions:
- A multimodality approach, specifically definitive CRT or surgery followed by CRT, is recommended for SCND.
- Neoadjuvant chemotherapy may aid in optimizing treatment selection for SCND.
