Feasibility of omitting contralateral neck irradiation in patients with node-negative sinonasal squamous cell carcinoma crossing the midline

Head Neck. 2023 Sep;45(9):2237-2245. doi: 10.1002/hed.27462. Epub 2023 Jul 14.

Abstract

Background: Identifying the lymph node target volume in patients with node-negative sinonasal squamous cell carcinoma (SNSCC) crossing the midline poses a challenge. This study aims to address this.

Methods: We retrospectively reviewed clinically N0 patients with tumors crossing the midline who received elective neck irradiation (ENI) from two centers between 1999 and 2019. The main endpoint was regional relapse-free survival (RRFS).

Results: We included 104 patients: 64 received bilateral ENI, and 40 received ipsilateral-only ENI (median follow-up time was 89.99 and 95.01 months, respectively). At 5 years, the RRFS rates were comparable (57.68% vs. 55.83%, p = 0.372), as were the contralateral RRFS (57.68% vs. 61.62%, p = 0.541). Five-year OS, LRFS, and DMFS showed no significant difference between two groups.

Conclusions: Our findings provide preliminary evidence suggesting the potential for avoiding contralateral ENI in SNSCC patients with midline crossing tumors who undergo ipsilateral ENI, covering at least level II. Validation through future prospective studies is necessary.

Keywords: contralateral regional relapse-free survival; crossing the midline; elective neck irradiation; regional relapse-free survival; sinonasal squamous cell carcinoma.

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / radiotherapy
  • Feasibility Studies
  • Humans
  • Lymphatic Metastasis
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Paranasal Sinus Neoplasms* / pathology
  • Paranasal Sinus Neoplasms* / radiotherapy
  • Prospective Studies
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / pathology