Clinical Features and Prognostic Insights in Sinonasal Sarcomas: A 76-Case Single-Institution Experience

This study analyzed the clinical characteristics, treatment outcomes, and prognostic factors of sinonasal sarcomas through a single-institution experience involving 76 cases over 27 years.

A retrospective review was conducted on 76 patients diagnosed with sinonasal sarcoma at a tertiary medical center from 1995 to 2022. Data collected included demographic information, tumor characteristics, and treatment modalities. Survival outcomes were assessed using Kaplan-Meier analysis, and prognostic factors were identified through univariate and multivariate Cox proportional hazards models.

The cohort included 45 males and 31 females, with a mean age of 42.6 years. The most common presenting symptom was nasal obstruction (22%). Rhabdomyosarcoma was the most prevalent subtype, accounting for 27.6% of cases. The 5- and 10-year overall survival (OS) rates were 62% and 56%, while the disease-free survival (DFS) rates were 51% and 41%. Survival outcomes were significantly worse in patients aged ≥ 61 years (p = 0.030), with a smoking history (p = 0.005), or with neurovascular extension (p = 0.015). In the univariate analysis, smoking history increased the mortality risk by 2.95-fold (p = 0.008) and neurovascular involvement by 2.87-fold (p = 0.020). Multivariate Cox analysis confirmed smoking history as an independent predictor of mortality (HR = 2.38, 95% CI: 1.05-5.40, p = 0.038).

The results showed that advanced age, smoking history, and neurovascular involvement were key contributors to reduced survival, with identified as a significant independent predictors of higher mortality risk. These findings offer critical insight into the therapeutic management of this rare malignancy.

4.