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

doi:10.1002/hed.24834

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

Research output: Contribution to journal › Article › peer-review

19 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 language	English (US)
Journal	Head and Neck
DOIs	https://doi.org/10.1002/hed.24834
State	Accepted/In press - 2017

Keywords

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

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.24834

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

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.",

keywords = "Intensity-modulated radiotherapy, Outcomes and patterns of failure, Radiotherapy, Sinonasal undifferentiated carcinoma, Trimodality therapy",

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

year = "2017",

doi = "10.1002/hed.24834",

language = "English (US)",

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T1 - Outcomes and patterns of failure for sinonasal undifferentiated carcinoma (SNUC)

T2 - The Mayo Clinic Experience

AU - Gamez, Mauricio E.

AU - Lal, Devyani

AU - Halyard, Michele Y.

AU - Wong, William W.

AU - Vargas, Carlos

AU - Ma, Daniel

AU - Ko, Stephen J.

AU - Foote, Robert L.

AU - Patel, Samir H.

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

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KW - Trimodality therapy

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