Prognostic Factors in Sinonasal Cancers: A Multicenter Pooled Analysis

Area of Science:

• Oncology
• Head and Neck Surgery
• Cancer Research

Background:

• Sinonasal cancers (SNC) are a diverse group of malignancies with varying clinical outcomes.
• Identifying specific prognostic factors is crucial for tailoring treatment strategies in non-metastatic (M0) SNC.

Purpose of the Study:

• To identify key prognostic factors influencing survival and recurrence in patients with non-metastatic sinonasal cancers.
• To analyze the impact of histology, tumor stage, and nodal status on locoregional failure, distant metastasis, and overall mortality.

Main Methods:

• Retrospective review of electronic health records for 376 M0-SNC patients treated at two tertiary institutions.
• Multivariable analysis (MVA) was employed to determine adjusted hazard ratios (aHR) for various prognostic factors.
• p16 staining was performed for the squamous cell carcinoma (SCC) subset.

Main Results:

• Histology significantly impacts outcomes: mucosal melanoma (MM), adenoid cystic carcinoma (ACC), and sinonasal undifferentiated carcinoma/neuroendocrine tumors (SNUC/SNEC) showed higher risks for distant metastasis.
• Advanced tumor stage (T3-4) and nodal involvement were associated with increased risk of locoregional failure and mortality.
• MM histology, older age, T3-4 tumors, and nodal involvement were linked to higher mortality risk.

Conclusions:

• Different SNC histologies demonstrate distinct patterns of relapse and survival.
• These findings underscore the necessity for individualized management strategies based on specific SNC histology and stage.