Relationship Between Anatomical Site and Prognosis for Sinonasal Cancers

Is there a connection between anatomical location and survival for various sinonasal cancers?

Background: Sinonasal malignancies are relatively rare but aggressive tumors. Squamous cell carcinomas are the most common, reported to constitute more than 40% of cases. Due to the insidious progression of sinonasal malignancies, patients tend to initially present in later stages, with a poor prognosis. The authors sought to uncover a connection between anatomical location and survival for various sinonasal cancers.

Study design: Retrospective analysis of 13,295 cases of sinonasal malignancies diagnosed between 1973 and 2011.

Setting: United States National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registry.

Synopsis: The highest number of cases were localized in the nasal cavity and the lowest in the frontal sinus. Squamous cell neoplasms were the most common malignancies, regardless of site. The four most common overall histological subtypes were epithelial neoplasms, not otherwise specified (NOS), squamous cell carcinoma, adenocarcinoma, and mature B-cell non-Hodgkin lymphoma (NHL). Most cancers were discovered at stage I for the nasal cavity and at stage IV for the maxillary and ethmoid sinuses. Frontal sinus cancers carried the worst prognosis at 10 years, while nasal cavity cancers carried the best prognosis. Surgery had higher survival than no treatment across all subsites except for the frontal sinus, and combination surgery and radiotherapy had higher survival than radiotherapy alone across all subsites except for the sphenoid sinus. Limitations included a lack of details about specific surgical approaches, radiotherapies, and associated patient medical conditions, as well as changes in technology and management strategies over the time period studied.

Bottom line: By anatomical site, prognosis is best for nasal cavity cancers and worst for overlapping lesions. Survival seems to be best with surgery at every subsite except for the frontal sinus.

Citation: Dutta R, Dubal PM, Svider PF, Liu JK, Baredes S, Eloy JA. Sinonasal malignancies: a population-based analysis of site-specific incidence and survival. Laryngoscope. 2015;125:2491-2497.