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J Neurol Surg B Skull Base 2021; 82(S 03): e114-e119
DOI: 10.1055/s-0040-1710516
Original Article

Prognostic Impact of Adverse Pathologic Features in Sinonasal Squamous Cell Carcinoma

Anuraag S. Parikh
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2   Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
,
Jennifer C. Fuller
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2   Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
,
Ashton E. Lehmann
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2   Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
,
Neerav Goyal
3   Department of Otolaryngology-Head and Neck Surgery, Penn State University, Hershey, Pennsylvania, United States
,
Stacey T. Gray
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2   Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
,
Derrick T. Lin
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2   Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
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Abstract

Objective This study aimed to describe the impact of adverse clinical and pathologic features in sinonasal squamous cell carcinoma (SCC).

Design This study is designed with retrospective chart review.

Setting The present study is conducted at a tertiary care institution.

Participants All patients treated surgically for sinonasal SCC at our tertiary care institution between January 2006 and December 2013.

Main Outcome Measures Overall survival (OS) and disease free survival (DFS) are the final measurement of this study.

Results Forty-eight patients were identified. Mean age at surgery was 65.8 years, and mean follow-up time was 40.7 months. Eighteen patients (38%) had T1–T3 disease, while 30 patients (63%) had T4 disease. Seven patients (8.3%) had nodal disease at presentation. At 2, 5, and 10 years, OS was 71, 54, and 48%, respectively, while DFS was 64, 51, and 45%, respectively. Twelve patients (25%) experienced local recurrences with mean time to recurrence of 15.3 months. Twenty-five patients (52%) had positive margins, 24 (50%) had high-grade tumors, 18 (38%) had perineural invasion (PNI), and 15 (31%) had lymphovascular invasion (LVI). In the univariate analysis, T4 disease (risk ratio [RR] = 2.7) and high grade (RR = 2.4) had a significant association with DFS. In the multivariate analysis, high grade (RR = 4.0 and 4.5) and LVI (RR = 4.1 and 4.7) had a significant association with OS and DFS.

Conclusion Our single-institution experience of 48 patients suggests that high grade and LVI are independently associated with survival outcomes in sinonasal SCC, while PNI and microscopically positive margins do not have a significant impact.

Keywords

sinonasal squamous cell carcinoma - lymphovascular invasion - grade - perineural invasion

Note

This article was presented as podium presentation at the North American Skull Base Society Meeting, February 16–18, 2018, Coronado, California, United States.




Publication History

Received: 14 October 2019

Accepted: 17 March 2020

Article published online:
19 May 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Lewis Jr JS. Sinonasal squamous cell carcinoma: a review with emphasis on emerging histologic subtypes and the role of human papillomavirus. Head Neck Pathol 2016; 10 (01) 60-67
    CrossrefPubMedGoogle Scholar
  • 2 Resto VA, Deschler DG. Sinonasal malignancies. Otolaryngol Clin North Am 2004; 37 (02) 473-487
    CrossrefPubMedGoogle Scholar
  • 3 Sanghvi S, Khan MN, Patel NR, Yeldandi S, Baredes S, Eloy JA. Epidemiology of sinonasal squamous cell carcinoma: a comprehensive analysis of 4994 patients. Laryngoscope 2014; 124 (01) 76-83
    CrossrefPubMedGoogle Scholar
  • 4 Subramaniam N, Balasubramanian D, Murthy S, Limbachiya S, Thankappan K, Iyer S. Adverse pathologic features in early oral squamous cell carcinoma and the role of postoperative radiotherapy-a review. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124 (01) 24-31
    CrossrefPubMedGoogle Scholar
  • 5 Robin TP, Jones BL, Gordon OM. et al. A comprehensive comparative analysis of treatment modalities for sinonasal malignancies. Cancer 2017; 123 (16) 3040-3049
    CrossrefPubMedGoogle Scholar
  • 6 Devaraja K, Sikka K, Kumar R, Thakar A. Sinonasal malignancies: long term follow up after surgical management-an analysis of outcomes. Indian J Otolaryngol Head Neck Surg 2015; 67 (01) 28-33
    CrossrefPubMedGoogle Scholar
  • 7 Paré A, Blanchard P, Rosellini S. et al. Outcomes of multimodal management for sinonasal squamous cell carcinoma. J Craniomaxillofac Surg 2017; 45 (08) 1124-1132
    CrossrefPubMedGoogle Scholar
  • 8 Goldson TM, Han Y, Knight KB, Weiss HL, Resto VA. Clinicopathological predictors of lymphatic metastasis in HNSCC: implications for molecular mechanisms of metastatic disease. J Exp Ther Oncol 2010; 8 (03) 211-221
    PubMedGoogle Scholar
  • 9 Adel M, Kao HK, Hsu CL. et al. Evaluation of lymphatic and vascular invasion in relation to clinicopathological factors and treatment outcome in oral cavity squamous cell carcinoma. Medicine (Baltimore) 2015; 94 (43) e1510
    CrossrefPubMedGoogle Scholar
  • 10 Lobo BC, D'Anza B, Farlow JL. et al. Outcomes of sinonasal squamous cell carcinoma with and without association of inverted papilloma: A multi-institutional analysis. Am J Rhinol Allergy 2017; 31 (05) 305-309
    CrossrefPubMedGoogle Scholar
  • 11 Unsal AA, Dubal PM, Patel TD. et al. Squamous cell carcinoma of the maxillary sinus: A population-based analysis. Laryngoscope 2016; 126 (02) 399-404
    CrossrefPubMedGoogle Scholar
  • 12 Turner JH, Reh DD. Incidence and survival in patients with sinonasal cancer: a historical analysis of population-based data. Head Neck 2012; 34 (06) 877-885
    CrossrefPubMedGoogle Scholar
  • 13 Yan CH, Newman JG, Kennedy DW, Palmer JN, Adappa ND. Clinical outcomes of sinonasal squamous cell carcinomas based on tumor etiology. Int Forum Allergy Rhinol 2017; 7 (05) 508-513
    CrossrefPubMedGoogle Scholar
  • 14 Gil Z, Carlson DL, Gupta A. et al. Patterns and incidence of neural invasion in patients with cancers of the paranasal sinuses. Arch Otolaryngol Head Neck Surg 2009; 135 (02) 173-179
    CrossrefPubMedGoogle Scholar