The Role of Regional Disease and Patterns of Treatment Failure in Primary Sinonasal Malignancies

Am J Rhinol Allergy. 2022 Jan;36(1):157-166. doi: 10.1177/19458924211033402. Epub 2021 Jul 22.

Abstract

Background: The question how to treat the clinically negative neck in sinonasal malignancies is controversial.

Objectives: To investigate patterns of treatment failure and to assess outcome measures in patients with primary sinonasal malignancies.

Methods: Retrospective cohort study of patients treated for primary malignant sinonasal malignancies.

Results: Lymph node (LN) metastases at initial presentation were present in 8 of 152 patients (5.3%). Ipsi- and contralateral LN levels 1 and 2 were identified as nodal basins at risk. We found a 5-year overall survival (OS) of 75.2% and disease free survival of 61.1%. Among patients with cN0 neck, nodal recurrence free survival was not different between patients with and without elective neck treatment (P = .23). On logistic regression analysis, we found initial T classification as an independent factor for achievement of complete remission (CR) and OS.

Conclusions: LN metastases at initial presentation are rare and initial T classification was identified as the most important prognostic factor for OS and CR, emphasizing the need for a thorough initial staging of the primary tumor.

Keywords: failure; lymph node; malignancy; metastases; neck; radiotherapy; recurrence; sinonasal; surgery; treatment.

MeSH terms

  • Disease-Free Survival
  • Humans
  • Lymphatic Metastasis
  • Neoplasm Staging
  • Retrospective Studies*
  • Treatment Failure