Morphological variability and its impact on survival in sinonasal malignancies: a 13-year analysis

Despites a tripling of recognised occupational sinonasal adenocarcinomas in the past three decades, no comprehensive publications of the epidemiological development and histological distribution of sinonasal malignancies exist in Germany. Therefore, this study aims to analyse population-related data and address gaps in the nationwide cancer registry.

The German Center for Cancer Registry Data (ZfKD) provided a dataset covering the period from 2003 to 2015. 8332 cases were extracted, morphologically clustered and underwent descriptive analysis. Incidence and mortality rates were standardised, and overall survival (OS) probability was estimated.

Standardised incidence rates increased, averaging 1.8 for men and 1.0 for women per 100,000 inhabitants. Sinonasal cancer manifested mostly in the nasal cavity with a 5-year OS of 63%. In contrast, malignancies in the frontal sinus had a less favourable survival probability (p < 0.001). Morphologically, the tumour entities comprised 55% squamous cell carcinomas, 18% adenocarcinomas, 8% mucosal melanomas, 4% esthesioneuroblastomas and 2% sinonasal undifferentiated carcinomas (SNUC). The highest 5-year OS rate was observed in esthesioneuroblastomas (59%), while SNUC (38%) and mucosal melanoma (29%) had the lowest (p < 0.001).

This study provides a comprehensive epidemiological analysis of sinonasal morphologies based on a unique dataset. Findings reveal a higher incidence and lower survival probability among men. The topographical distribution varies by sex and tumour entity. The mortality rate for patients with sinonasal cancer is moderate to high, particularly for SNUC and mucosal melanoma, with incidences of 8.4% and 2%, respectively. Hence, there is an urgent need for an optimised screening for early-stage malignancies.