Outcomes and patterns of failure for sinonasal undifferentiated carcinoma (SNUC): The Mayo Clinic Experience

Mauricio E. Gamez, Devyani Lal, Michele Y. Halyard, William W. Wong, Carlos Vargas, Daniel Ma, Stephen J. Ko, Robert L. Foote, Samir H. Patel

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11 Scopus citations

Abstract

Background: Sinonasal undifferentiated carcinoma (SNUC) is a rare aggressive disease arising in the nasal cavity and paranasal sinuses with poor prognosis and unclear optimal management. Methods: Forty patients were analyzed. Nasal cavity was the most common primary site. Most patients presented with T4 disease, received trimodality therapy, and were treated with intensity-modulated radiotherapy (IMRT). Results: Median follow-up was 6.9 years. Sixteen patients (40%) experienced recurrent disease, 5 local (12.5%), 1 regional (2.5%), and 10 distant (25%). The 5-year overall survival (OS), recurrence-free survival (RFS), and locoreginal control (LRC) were 44%, 39%, and 71%, respectively. Patients treated with trimodality therapy had better outcomes compared to single modality therapy. Improved OS was noted with IMRT and with doses ≥60 Gy. The most common cause of death was distant metastasis. Conclusion: SNUC is an aggressive malignancy with a high tendency to metastasize. Better outcomes were obtained with a trimodality approach. Modern radiotherapy (RT) techniques and doses≥60 Gy were associated with improved OS.

Original languageEnglish (US)
JournalHead and Neck
DOIs
StateAccepted/In press - 2017

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Keywords

  • Intensity-modulated radiotherapy
  • Outcomes and patterns of failure
  • Radiotherapy
  • Sinonasal undifferentiated carcinoma
  • Trimodality therapy

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Gamez, M. E., Lal, D., Halyard, M. Y., Wong, W. W., Vargas, C., Ma, D., Ko, S. J., Foote, R. L., & Patel, S. H. (Accepted/In press). Outcomes and patterns of failure for sinonasal undifferentiated carcinoma (SNUC): The Mayo Clinic Experience. Head and Neck. https://doi.org/10.1002/hed.24834