Ester Orlandi1, Stefano Cavalieri2, Roberta Granata2, Piero Nicolai3, Paolo Castelnuovo4, Cesare Piazza5, Alberto Schreiber3, Mario Turri-Zanoni4, Pasquale Quattrone6, Rosalba Miceli7, Gabriele Infante7, Fausto Sessa8, Carla Facco8, Giuseppina Calareso9, Nicola Alessandro Iacovelli1, Davide Mattavelli3, Alberto Paderno3, Carlo Resteghini2, Laura Deborah Locati, Lisa Licitra2,10, Paolo Bossi2,11. 1. Radiation Oncology Department, The University of Milan, Milan. 2. the Head and Neck Medical Oncology Department, The University of Milan, Milan. 3. the Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia. 4. the Department of Otorhinolaryngology, University of Insubria and ASST Sette Laghi, Ospedale di Circolo, Varese, Italy. 5. the Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, The University of Milan, Milan. 6. the Department of Pathology and Laboratory Medicine, The University of Milan, Milan. 7. the Unit of Clinical Epidemiology and Trial Organization, The University of Milan, Milan. 8. the Department of Pathology, University of Insubria and ASST Sette Laghi, Ospedale di Circolo, Varese, Italy. 9. the Department of Interventional Radiology, The University of Milan, Milan. 10. Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, the University of Milan, Milan. 11. the University of Brescia, Brescia.
Abstract
OBJECTIVE: Outcomes of locally advanced epithelial sinonasal cancers remain unsatisfactory; moreover, only limited and heterogeneous data exist on prognostic factors. METHODS: We reviewed all consecutive patients with American Joint Committee Cancer stage III to IV epithelial sinonasal cancers treated with platinum-based induction chemotherapy (IC) followed by locoregional treatment between 1996 and 2015. RESULTS: We identified 69 patients treated with a multimodal approach (IC, surgery, radiotherapy). Overall, 44 patients recurred (64%). Of those, 19 patients received salvage surgery, but only four remained disease-free. Median overall survival (OS) was 62.5 months. Sinonasal neuroendocrine and small cell histotypes (P = 0.0085), neuroendocrine differentiation (P = 0.006), and lack of response to IC (P = 0.03) were associated with worse OS. In patients who recurred, median OS was 13 months since recurrence. Survival was longer in patients submitted to salvage surgery (44%) than in those receiving chemotherapy alone at recurrence (29.5 vs. 4.6 months). Patients with a clinical benefit after palliative chemotherapy had a longer median OS than those with disease progression (29.2 vs. 4.4 months; P < 0.0001). CONCLUSION: Globally, the prognosis of locally advanced epithelial sinonasal cancers is dismal, with worse outcomes for neuroendocrine lesions. In the recurrent setting, feasibility of salvage surgery and clinical benefit from palliative chemotherapy are associated with longer OS. A multimodal treatment strategy with IC seems to offer improved OS when compared with other retrospective series not employing such a therapeutic tool. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:857-865, 2020.
OBJECTIVE: Outcomes of locally advanced epithelial sinonasal cancers remain unsatisfactory; moreover, only limited and heterogeneous data exist on prognostic factors. METHODS: We reviewed all consecutive patients with American Joint Committee Cancer stage III to IV epithelial sinonasal cancers treated with platinum-based induction chemotherapy (IC) followed by locoregional treatment between 1996 and 2015. RESULTS: We identified 69 patients treated with a multimodal approach (IC, surgery, radiotherapy). Overall, 44 patients recurred (64%). Of those, 19 patients received salvage surgery, but only four remained disease-free. Median overall survival (OS) was 62.5 months. Sinonasal neuroendocrine and small cell histotypes (P = 0.0085), neuroendocrine differentiation (P = 0.006), and lack of response to IC (P = 0.03) were associated with worse OS. In patients who recurred, median OS was 13 months since recurrence. Survival was longer in patients submitted to salvage surgery (44%) than in those receiving chemotherapy alone at recurrence (29.5 vs. 4.6 months). Patients with a clinical benefit after palliative chemotherapy had a longer median OS than those with disease progression (29.2 vs. 4.4 months; P < 0.0001). CONCLUSION: Globally, the prognosis of locally advanced epithelial sinonasal cancers is dismal, with worse outcomes for neuroendocrine lesions. In the recurrent setting, feasibility of salvage surgery and clinical benefit from palliative chemotherapy are associated with longer OS. A multimodal treatment strategy with IC seems to offer improved OS when compared with other retrospective series not employing such a therapeutic tool. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:857-865, 2020.
Authors: Stefano Cavalieri; Daria Maria Filippini; Arianna Ottini; Cristiana Bergamini; Carlo Resteghini; Elena Colombo; Roberta Lombardo; Imperia Nuzzolese; Salvatore Alfieri; Lisa Licitra; Laura D Locati Journal: Explor Target Antitumor Ther Date: 2021-12-31
Authors: Olena Klymenko; Anna Maria Stefanie Buchberger; Barbara Wollenberg; Klaus-Dietrich Wolff; Victoria Kehl; Stephanie E Combs; Anja Pickhard; Steffi U Pigorsch Journal: Cancers (Basel) Date: 2021-05-14 Impact factor: 6.639