title: Significance of Tumor Stage in Sinonasal Undifferentiated Carcinoma Survival: A Population-Based Analysis.
abstract: OBJECTIVE
  To describe the incidence and determinants of survival of patients with sinonasal undifferentiated carcinoma (SNUC) from 1973 to 2011 using the SEER database (Surveillance, Epidemiology, and End Results), with consideration of tumor stage based on the Kadish system.
  
  
  METHODS
  Retrospective database analysis.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  The SEER registry was utilized to calculate survival trends for 328 patients with SNUC between 1973 and 2011. Patient data were then analyzed with respect to histopathology, age, sex, race, subsite, modified Kadish stage, tumor size, and treatments rendered.
  
  
  RESULTS
  The cohort was composed of 61.9% males with median age of 60 years. The median overall survival (OS) was 1.9 years. Most tumors presented in the nasal cavity, maxillary sinus, and ethmoid sinus (29.3%, 27.4%, 21%, respectively); 43.7% of patients received both surgical and radiation therapy. OS at 2, 5, and 10 years was 43%, 30%, and 25%, respectively. On univariate analysis, age, Kadish stage, and tumor size were associated with worse OS and disease-specific survival (DSS), while surgery and radiation therapy were associated with improved OS and DSS (all P < .05). On multivariate analysis, radiation therapy and lower Kadish stage were associated with improved OS and DSS, while younger age was additionally associated with improved OS (all P < .05).
  
  
  CONCLUSIONS
  SNUC is a rare but aggressive sinonasal malignancy. Tumor stage as determined by the Kadish system is associated with worse survival, with radiation therapy appearing to play a key role in therapeutic management.
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA ewu@mednet.ucla.edu.
authors.forename: Edward C
authors.initials: EC
authors.lastname: Kuan
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Armin
authors.initials: A
authors.lastname: Arshi
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Jon
authors.initials: J
authors.lastname: Mallen-St Clair
authors.affiliation: Division of Rhinology, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Bobby A
authors.initials: BA
authors.lastname: Tajudeen
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Elliot
authors.initials: E
authors.lastname: Abemayor
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA Jonsson Comprehensive Cancer Center, UCLA Medical Center, Los Angeles, California, USA UCLA Head and Neck Cancer Program, UCLA Medical Center, Los Angeles, California, USA.
authors.forename: Maie A
authors.initials: MA
authors.lastname: St John
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010255:Paranasal Sinus Neoplasms / Q000473:pathology* / Q000628:therapy; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D018426:SEER Program; D015996:Survival Rate; D014481:United States
keywords: epidemiology; outcomes; sinonasal undifferentiated carcinoma