Sinonasal Undifferentiated Carcinoma: The Experience of One Multidisciplinary Team over a 10-Year Period

Background: Sinonasal undifferentiated carcinoma (SNUC) is a rare and aggressive malignancy arising within the sinonasal cavities. Patients typically present with locally advanced disease. As SNUC is a rare pathology, there is limited evidence based on its treatment. The largest published case series includes 36 patients, and a 2012 meta-analysis of 30 articles includes only 167 cases. This study estimates that the 2-year disease free survival is just 26%. However, more recent series that include trimodality treatment with surgery and chemoradiotherapy (CRT) show a trend for improved survival. We work within a multidisciplinary team (MDT) and feel that this improves our patients' outcomes through the use of oncological and surgical options. We present our outcomes over a 10-year period. Methods: Retrospective review of prospectively collected operative database, histopathology reports, clinical records, and MDT records. Results: We identified 18 patients who presented to our team with SNUC. Overall 14 were treated with multimodality treatment, including surgery, radiotherapy, and chemotherapy. Two patients underwent surgical excision only, and two underwent CRT only. The 3 year overall survival was 58%. Nodal metastasis at presentation conferred a poor prognosis. Conclusions: This series, in keeping with other published series, indicates that multidisciplinary management of SNUC confers an improved prognosis.