title: Treatment outcomes and prognostic factors, including human papillomavirus, for sinonasal undifferentiated carcinoma: a retrospective review.
abstract: BACKGROUND
  Sinonasal undifferentiated carcinoma (SNUC) is a high-grade, aggressive neoplasm. Low incidence and poor outcomes make identification of prognostic factors and treatment standardization difficult. Similarly, little is known regarding the association of human papillomavirus (HPV) with SNUC.
  
  
  METHODS
  A retrospective review was conducted. Extracted information included treatment received, tumor recurrence, patient survival, p16 expression, and HPV status. The Kaplan-Meier method was used to estimate overall survival (OS) and disease-free survival (DFS). Survival trends were compared using the log-rank test.
  
  
  RESULTS
  Nineteen patients received multimodality treatment for SNUC. Five-year OS and DFS rates were 45.2% and 50.7%, respectively, with no significant difference between treatment types. Tumors from 11 patients were p16-positive and 9 of these were also HPV-positive. Kaplan-Meier analysis demonstrated improved survival.
  
  
  CONCLUSIONS
  Our series demonstrates a higher prevalence of HPV in SNUC than previously reported. HPV-positive SNUCs may benefit from improved survival and should be investigated further in future studies.
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts; Massachusetts Eye and Ear Infirmary/Massachusetts General Hospital Cranial Base Center, Boston, Massachusetts.
authors.forename: Stacey T
authors.initials: ST
authors.lastname: Gray
authors.forename: Marc W
authors.initials: MW
authors.lastname: Herr
authors.forename: Rosh K V
authors.initials: RK
authors.lastname: Sethi
authors.forename: Gillian
authors.initials: G
authors.lastname: Diercks
authors.forename: Linda
authors.initials: L
authors.lastname: Lee
authors.forename: William
authors.initials: W
authors.lastname: Curry
authors.forename: Annie
authors.initials: A
authors.lastname: Chan
authors.forename: John
authors.initials: J
authors.lastname: Clark
authors.forename: Eric H
authors.initials: EH
authors.lastname: Holbrook
authors.forename: James
authors.initials: J
authors.lastname: Rocco
authors.forename: Peter M
authors.initials: PM
authors.lastname: Sadow
authors.forename: Derrick T
authors.initials: DT
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy* / Q000821:virology; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy* / Q000821:virology; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000628:therapy; D010255:Paranasal Sinus Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy* / Q000821:virology; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
keywords: human papillomavirus; p16; sinonasal malignancy; sinonasal undifferentiated carcinoma; treatment