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European Archives of Oto-Rhino-Laryngology

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01-11-2019 | Radiotherapy | Rhinology

Comparative outcome of surgical and nonsurgical therapy for T4bN0M0 sinonasal squamous cell carcinomas

Authors: Ruichen Li, Shu Tian, Lan Lin, Quan Liu, Shengzi Wang

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2019

Abstract

Purpose

Definitive radiotherapy (RT) is recommended by NCCN guidelines for T4b tumors of sinonasal squamous cell carcinomas (SNSCC). However, no multi-institutional clinical studies have proved its advantage over surgery-based modalities. The aim of this study was to assess the survival of T4bN0M0 SNSCC patients who received surgery plus postoperative radiation (S + PORT) compared with those who received RT.

Methods

This study extracted 220 patients from the SEER database from 2004 to 2015. Propensity score matching (PSM) was used to eliminate the baseline variations.

Results

In SEER database, 43.6% of patients received S + PORT, and subsequently followed by RT (36.4%). Five-year overall survival (OS) and cancer-specific survival rates (CSS) in S + PORT were 42.5% and 46.9%, respectively, significantly better than for RT (21.7% and 26.7%). Multivariate analysis showed that therapy of RT had higher cancer-specific mortality risk than S + PORT [hazard ratio (HR) 1.578, p = 0.032]. After PSM, 57 pairs of patients were selected. There was still a significant difference noted with regard to 5-year OS or 5-year CSS between patients receiving S + PORT and RT (43% vs 22.5%, p = 0.012; 45.8% vs 27.7%, p = 0.025). The univariate and multivariate analyses of factors predictive of CSS showed that therapy of RT (HR 1.877, p = 0.018) and primary subsite of maxillary sinus (HR 2.629, p = 0.001) were significantly correlated with adverse outcomes.

Conclusion

Combination of surgery and postoperative radiotherapy may contribute to prolonged survival in T4bN0M0 SNSCC. Invasion of the sites of T4b tumors is not an absolute contraindication for surgery.

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Michel J, Fakhry N, Mancini J, Braustein D, Moreddu E, Giovanni A, Dessi P (2014) Sinonasal squamous cell carcinomas: clinical outcomes and predictive factors. Int J Oral Maxillofac Surg 43:1–6CrossRefPubMed

Robin TP, Jones BL, Gordon OM, Phan A, Abbott D, McDermott JD, Goddard JA, Raben D, Lanning RM, Karam SD (2017) A comprehensive comparative analysis of treatment modalities for sinonasal malignancies. Cancer Am Cancer Soc 123:3040–3049

Turner JH, Reh DD (2012) Incidence and survival in patients with sinonasal cancer: a historical analysis of population-based data. Head Neck 34:877–885CrossRefPubMed

Ansa B, Goodman M, Ward K, Kono SA, Owonikoko TK, Higgins K, Beitler JJ, Grist W, Wadsworth T, El-Deiry M, Chen AY, Khuri FR, Shin DM, Saba NF (2013) Paranasal sinus squamous cell carcinoma incidence and survival based on Surveillance, Epidemiology, and End Results data, 1973 to 2009. Cancer Am Cancer Soc 119:2602–2610

Youlden DR, Cramb SM, Peters S, Porceddu SV, Moller H, Fritschi L, Baade PD (2013) International comparisons of the incidence and mortality of sinonasal cancer. Cancer Epidemiol 37:770–779CrossRefPubMed

Llorente JL, Lopez F, Suarez C, Hermsen MA (2014) Sinonasal carcinoma: clinical, pathological, genetic and therapeutic advances. Nat Rev Clin Oncol 11:460–472CrossRefPubMed

Bossi P, Farina D, Gatta G, Lombardi D, Nicolai P, Orlandi E (2016) Paranasal sinus cancer. Crit Rev Oncol Hematol 98:45–61CrossRefPubMed

Lisan Q, Kolb F, Temam S, Tao Y, Janot F, Moya-Plana A (2016) Management of orbital invasion in sinonasal malignancies. Head Neck 38:1650–1656CrossRefPubMed

Safi AF, Behn L, Rothamel D, Guntinas-Lichius O, Beutner D, Nickenig HJ, Zoller J, Kreppel M (2017) Therapy of sinonasal malignancies invading the orbit-orbital exenteration versus preservation of the orbit plus radiotherapy. J Craniomaxillofac Surg 45:258–261CrossRefPubMed

10.

Muscatello L, Fortunato S, Seccia V, Marchetti M, Lenzi R (2016) The implications of orbital invasion in sinonasal tract malignancies. Orbit 35:278–284CrossRefPubMed

11.

Chen AM, Daly ME, Bucci MK, Xia P, Akazawa C, Quivey JM, Weinberg V, Garcia J, Lee NY, Kaplan MJ, El-Sayed I, Eisele DW, Fu KK, Phillips TL (2007) Carcinomas of the paranasal sinuses and nasal cavity treated with radiotherapy at a single institution over five decades: are we making improvement? Int J Radiat Oncol Biol Phys 69:141–147CrossRefPubMed

12.

Chopra S, Kamdar DP, Cohen DS, Heilbrun LK, Smith D, Kim H, Lin HS, Jacobs JR, Yoo G (2017) Outcomes of nonsurgical management of locally advanced carcinomas of the sinonasal cavity. Laryngoscope 127:855–861CrossRefPubMed

13.

Bossi P, Saba NF, Vermorken JB, Strojan P, Pala L, de Bree R, Rodrigo JP, Lopez F, Hanna EY, Haigentz M, Takes RP, Slootweg PJ, Silver CE, Rinaldo A, Ferlito A (2015) The role of systemic therapy in the management of sinonasal cancer: a critical review. Cancer Treat Rev 41:836–843CrossRefPubMed

14.

Hoppe BS, Nelson CJ, Gomez DR, Stegman LD, Wu AJ, Wolden SL, Pfister DG, Zelefsky MJ, Shah JP, Kraus DH, Lee NY (2008) Unresectable carcinoma of the paranasal sinuses: outcomes and toxicities. Int J Radiat Oncol Biol Phys 72:763–769CrossRefPubMed

15.

Sakata K, Maeda A, Rikimaru H, Ono T, Koga N, Takeshige N, Tokutomi T, Umeno H, Kiyokawa K, Morioka M (2016) Advantage of extended craniofacial resection for advanced malignant tumors of the nasal cavity and paranasal sinuses: long-term outcome and surgical management. World Neurosurg 89:240–254CrossRefPubMed

16.

de Almeida JR, Su SY, Koutourousiou M, Vaz GFF, Fernandez MJ, Wang EW, Gardner PA, Snyderman CH (2015) Endonasal endoscopic surgery for squamous cell carcinoma of the sinonasal cavities and skull base: oncologic outcomes based on treatment strategy and tumor etiology. Head Neck 37:1163–1169CrossRefPubMed

17.

Snyderman CH, Carrau RL, Kassam AB, Zanation A, Prevedello D, Gardner P, Mintz A (2008) Endoscopic skull base surgery: principles of endonasal oncological surgery. J Surg Oncol 97:658–664CrossRefPubMed

18.

Farag A, Rosen M, Evans J (2015) Surgical techniques for sinonasal malignancies. Neurosurg Clin N Am 26:403–412CrossRefPubMed

19.

Le QT, Fu KK, Kaplan MJ, Terris DJ, Fee WE, Goffinet DR (2000) Lymph node metastasis in maxillary sinus carcinoma. Int J Radiat Oncol Biol Phys 46:541–549CrossRefPubMed

20.

Lee YC, Lee TJ, Tsang NM, Huang Y, Hsu CL, Hsin LJ, Lee YH, Chang KP (2018) Cavernous sinus involvement is not a risk factor for the primary tumor site treatment outcome of Sinonasal adenoid cystic carcinoma. J Otolaryngol Head Neck Surg 47:12CrossRefPubMedPubMedCentral

21.

Sugawara T, Aoyagi M, Ogishima T, Kawano Y, Tamaki M, Yano T, Tsunoda A, Ohno K, Maehara T, Kishimoto S (2015) Extended orbital exenteration for sinonasal malignancy with orbital apex extension: surgical technique and clinical analysis. J Neurosurg 123:52–58CrossRefPubMed

22.

Jansen EP, Keus RB, Hilgers FJ, Haas RL, Tan IB, Bartelink H (2000) Does the combination of radiotherapy and debulking surgery favor survival in paranasal sinus carcinoma? Int J Radiat Oncol Biol Phys 48:27–35CrossRefPubMed

23.

Resto VA, Chan AW, Deschler DG, Lin DT (2008) Extent of surgery in the management of locally advanced sinonasal malignancies. Head Neck 30:222–229CrossRefPubMed

24.

Kawashima M, Ogino T, Hayashi R, Ishikura S, Nihei K, Ito Y, Ikeda H, Ebihara S, Itai Y (2001) Influence of postsurgical residual tumor volume on local control in radiotherapy for maxillary sinus cancer. Jpn J Clin Oncol 31:195–202CrossRefPubMed

25.

Chen NX, Chen L, Wang JL, Wang JY, Yan F, Ma L, Zhang XX (2016) A clinical study of multimodal treatment for orbital organ preservation in locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinus. Jpn J Clin Oncol 46:727–734CrossRefPubMed

26.

Homma A, Oridate N, Suzuki F, Taki S, Asano T, Yoshida D, Onimaru R, Nishioka T, Shirato H, Fukuda S (2009) Superselective high-dose cisplatin infusion with concomitant radiotherapy in patients with advanced cancer of the nasal cavity and paranasal sinuses: a single institution experience. Cancer Am Cancer Soc 115:4705–4714

27.

Li R, Tian S, Zhu Y, Yan L, Zhu W, Quan H, Wang S (2019) Management of orbital invasion in esthesioneuroblastoma: 14 years' experience. Radiat Oncol 14:107CrossRefPubMedPubMedCentral

Title: Comparative outcome of surgical and nonsurgical therapy for T4bN0M0 sinonasal squamous cell carcinomas
Authors: Ruichen Li
Shu Tian
Lan Lin
Quan Liu
Shengzi Wang
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keyword: Radiotherapy
Published in: European Archives of Oto-Rhino-Laryngology / Issue 11/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05601-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparative outcome of surgical and nonsurgical therapy for T4bN0M0 sinonasal squamous cell carcinomas

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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