Current concepts in sinonasal tumors: from pretherapeutic assessment to patient-tailored treatment

Managing sinonasal malignancies requires a thorough oncological assessment and interdisciplinary collaboration. Patients often present at an advanced tumor stage with a delay in diagnosis. With the recent advancements in imaging techniques along with the growth in molecular testing knowledge, the landscape of these tumors has become increasingly diverse. The pretreatment assessment must include information gathered from radiological and pathological evaluations, as well as intraoperative exploration of the tumors. Only a comprehensive approach allows a personalized treatment plan.

This narrative review synthesizes current evidence, encompassing pretherapeutic evaluations and the development of individualized treatment protocols.

Multimodal treatment strategies, including surgical resection, radiotherapy (RT), chemotherapy, and immunotherapy (for sinonasal mucosal melanoma) need to be tailored based on tumor histology, stage, and patient-specific factors. Endoscopic surgical approaches demonstrated oncologic outcomes comparable to traditional open techniques, with reduced perioperative morbidity. Neoadjuvant therapies facilitated improved local control and organ preservation in advanced-stage tumors.

Ongoing advancements in imaging, surgical interventions, as well as (neo)adjuvant therapies have significantly improved the prognostic landscape of sinonasal malignancies. A multidisciplinary, personalized treatment approach remains pivotal in optimizing patient outcomes.