title: Survival Outcomes for Combined Modality Therapy for Sinonasal Undifferentiated Carcinoma.
abstract: Objective Sinonasal undifferentiated carcinoma is a rare and aggressive malignancy of the nasal cavity and paranasal sinuses. Multi-institutional studies examining outcomes of combined modality treatment versus other treatment modalities have not been performed. The objective of our study was to present outcomes for multimodality therapy through use of the National Cancer Database. Study Design Retrospective cohort study. Setting National Cancer Database. Methods A total of 435 cases of SNUC diagnosed between 2004 and 2012 were identified. Kaplan-Meier analyses were performed to find 5-year cumulative survival rates. Multivariate Cox regression evaluated overall survival based on treatment when adjusting for other prognostic factors (age, primary site, sex, race, comorbidity, insurance, and TNM stage). Within the surgery + chemoradiotherapy group, survival analysis was also performed to compare outcomes for induction and adjuvant chemotherapy. Results The cumulative 5-year survival rate was 41.5%, and 36.1% of patients received surgery with chemoradiotherapy. In multivariate analysis, surgery + chemoradiotherapy was associated with significantly improved overall survival versus surgery + radiotherapy and radiotherapy but not significantly different from chemoradiotherapy. Within the surgery + chemoradiotherapy group, induction and adjuvant chemotherapy groups did not have associated differences in survival. Conclusion Combined modality therapy (chemoradiotherapy or surgery + chemoradiotherapy) is associated with improved survival outcomes versus other treatment modalities in patients with sinonasal undifferentiated carcinoma.
authors.affiliation: 1 Otolaryngology Section, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
authors.forename: Phoebe
authors.initials: P
authors.lastname: Kuo
authors.affiliation: 1 Otolaryngology Section, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
authors.forename: R Peter
authors.initials: RP
authors.lastname: Manes
authors.affiliation: 1 Otolaryngology Section, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
authors.forename: Zachary G
authors.initials: ZG
authors.lastname: Schwam
authors.affiliation: 1 Otolaryngology Section, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.|2 Yale Cancer Center, New Haven, Connecticut, USA.
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Judson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
keywords: SNUC; chemoradiation; sinonasal undifferentiated carcinoma; surgery; survival outcomes