title: Sinonasal undifferentiated carcinoma: the search for a better outcome.
abstract: OBJECTIVE
  To evaluate the clinical outcomes of a standardized treatment approach for sinonasal undifferentiated carcinoma (SNUC).
  
  
  METHODS
  Single-center, retrospective case series.
  
  
  METHODS
  Fifteen patients with newly diagnosed SNUC were seen in the Department of Otolaryngology-Head and Neck Surgery at the University of Virginia from 1991 to 2000. Long-term follow-up on five additional patients diagnosed between 1986 and 1991 was also analyzed.
  
  
  RESULTS
  Overall, 10 patients were treated with curative intent with neoadjuvant chemoradiotherapy followed by craniofacial resection (CFR). The majority of the remainder was treated with palliative radiotherapy or chemoradiotherapy alone. Four patients who underwent CFR are currently free of disease at 4, 36, 49, and 164 months postoperatively. The 2-year survival of all evaluable patients, regardless of treatment, was 47%. Two-year survival was 64% in the group treated by CFR and 25% in the group treated with chemo- and/or radiotherapy (P =.076).
  
  
  CONCLUSIONS
  For patients with good performance status and limited intracranial or intraorbital disease, we continue to advocate initial chemoradiotherapy followed by craniofacial resection. Patients who are deemed inoperable as a result of advanced disease may nevertheless experience significant palliation with chemoradiotherapy only.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, Virginia 22908, USA.
authors.forename: Pierre Y
authors.initials: PY
authors.lastname: Musy
authors.forename: James F
authors.initials: JF
authors.lastname: Reibel
authors.forename: Paul A
authors.initials: PA
authors.lastname: Levine
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome