Factors associated with a primary surgical approach for sinonasal squamous cell carcinoma

J Surg Oncol. 2018 Mar;117(4):756-764. doi: 10.1002/jso.24923. Epub 2017 Nov 28.

Abstract

Background and objectives: Primary surgery is the preferred treatment of T1-T4a sinonasal squamous cell carcinoma (SNSCC).

Methods: Patients with SNSCC in the National Cancer Data Base (NCDB) were analyzed. Factors that contributed to selecting primary surgical treatment were examined. Overall survival (OS) in surgical patients was analyzed.

Results: Four-thousand seven hundred and seventy patients with SNSCC were included. In T1-T4a tumors, lymph node metastases, maxillary sinus location, and treatment at high-volume centers were associated with selecting primary surgery. When primary surgery was utilized, tumor factors and positive margin guided worse OS. Adjuvant therapy improved OS in positive margin resection and advanced T stage cases.

Conclusions: Tumor and non-tumor factors are associated with selecting surgery for the treatment of SNSCC. When surgery is selected, tumor factors drive OS. Negative margin resection should be the goal of a primary surgical approach. When a positive margin resection ensues, adjuvant therapy may improve OS.

Keywords: adjuvant therapy; margin status; maxillary sinus; sinonasal squamous cell carcinoma (SNSCC); treatment selection.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery*
  • Chemoradiotherapy, Adjuvant
  • Cohort Studies
  • Female
  • Head and Neck Neoplasms / drug therapy
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Male
  • Margins of Excision
  • Middle Aged
  • Neoplasm Staging
  • Paranasal Sinus Neoplasms / drug therapy
  • Paranasal Sinus Neoplasms / pathology
  • Paranasal Sinus Neoplasms / radiotherapy
  • Paranasal Sinus Neoplasms / surgery*
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Rate