AUTHOR=Chen Meng-Yu , Wen Xin , Wei Yi , Chen Lin , Huang Zi-Xuan , Lu Tong , Zheng Nian-Zhen , Li Jian , Wen Wei-Ping , Wen Yi-Hui 

TITLE=Oncologic outcome of multimodality treatment for sinonasal malignancies: An 18-year experience

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.958142

DOI=10.3389/fonc.2022.958142

ISSN=2234-943X

ABSTRACT=Purpose: To retrospectively evaluate the oncologic outcomes of sinonasal malignancies (SNM) of various histologic subtypes and investigate the impact of multimodality treatment on prognosis of SNM.
Methods: SNM Patients treated with curative-intend from 2000 to 2018 was included. The primary outcomes were overall survival (OS). Survival was then assessed through Cox proportional hazards models.
Results: Three-hundred and three patients were eligible for the analysis. The 5-year OS and event-free survival (EFS) were 61.0% (95%CI 55.4% - 67.1%) and 46.2% (95%CI 40.4% - 52.7%). The 5-year OS was poorest for malignant melanoma and the best for adenocarcinoma. Patients who received surgery had better OS than who only receive radiotherapy and/or chemotherapy. Endoscopic surgery carried better OS than open approach (p<0.05). Microscopically margin-negative resection (R0 resection) significantly benefits for OS and EFS (p<0.001). No significant difference of OS was observed between patients received macroscopic complete resection (R1 resection) followed by adjuvant therapy and patients received R0 resection. Older age (HR = 1.02, P = 0.02), R1 resection (HR = 1.99, P = 0.02), sinonasal surgical history more than 3 months before diagnosis (HR = 2.77, P = 0.007), and radiotherapy history (HR = 3, P = 0.006) are risk factors of poorer EFS.
Conclusions: Curative-intent surgery is irreplaceable in treatment of SNM. Endoscopic approach is an effective alternative to open approach. EFS is poorer among patients with older age, R1 resection, sinonasal surgical history more than 3 months before diagnosis and radiotherapy history.