Sinonasal malignancies: histopathological entities, regional involvement and long-term outcome

J Otolaryngol Head Neck Surg. 2023 Apr 28;52(1):36. doi: 10.1186/s40463-023-00627-8.

Abstract

Background: To assess a large patient cohort with sinonasal malignancies focusing on regional involvement, recurrence and oncological outcome.

Methods: Patients (n = 144) with malignant tumors of the nasal cavity and paranasal sinuses were treated at our tertiary referral center between 2008 and 2019. A chart review on patient and tumor characteristics, treatment and long-term outcome was performed.

Results: Most frequent histological types were squamous cell carcinoma (SCC) (n = 74), adenocarcinoma (n = 24) and mucosal melanoma (n = 18). Primary therapy was surgery in 66% of patients (n = 95) of which 65.8% (n = 66) received adjuvant radiotherapy. Twenty patients (13.8%) were initially staged as cN + and in seven cases, pN + status was histopathologically confirmed. Fifty-six of 130 patients (43.1%) had a relapse after curative intended therapy, including nine loco-regional (6.9%) and seven isolated regional recurrences (5.4%). Twelve of these 16 patients with (loco-)regional recurrence had SCC. Adenoid cystic carcinoma (87.5%) and SCC (65.3%) showed the best long-term overall survival.

Conclusions: Regional involvement and regional recurrence are scarce. Because of rarity and heterogeneity, evidence on therapeutic management is sparse resulting in the lack of clinical guidelines.

Keywords: Mucosal melanoma; Nasal cancer; Rare cancer; Regional recurrence; Squamous cell carcinoma.

MeSH terms

  • Adenocarcinoma* / radiotherapy
  • Adenocarcinoma* / surgery
  • Carcinoma, Adenoid Cystic*
  • Carcinoma, Squamous Cell* / pathology
  • Humans
  • Neoplasm Recurrence, Local / pathology
  • Nose Neoplasms* / therapy
  • Paranasal Sinus Neoplasms* / pathology
  • Retrospective Studies