Recurrence Patterns and Efficacy of Surveillance Modalities for Sinonasal Malignancies

Am J Rhinol Allergy. 2022 Jul;36(4):473-479. doi: 10.1177/19458924221079963. Epub 2022 Mar 3.

Abstract

Objective: There is limited information regarding the recurrence patterns and efficacy of surveillance modalities in patients with sinonasal malignancies.

Methods: A retrospective study was conducted between the years 2001-2018 at a tertiary care center. Included were all patients with sinonasal malignancies treated in our institution. Data regarding recurrence and survival were analyzed.

Results: Eighty-one patients were included. Multimodal treatment was administered to the majority of patients. 24 (35.3%) patients recurred with a median time of 17 months (range, 4-180). Although the majority of recurrences occurred within the first 5 years (83.3%), 4 (16.6%) recurred later on (5-15 years). Recurrences were local in 83.3%, regional in 20.8% and distant in 16.6%. All local recurrences occurred within the radiation treatment field and all patients with distant failure had mucosal melanoma. The majority of recurrences (70.6%) were diagnosed clinically or endoscopically, mainly in patients with SCC during the first 2 years of follow up. MRI or PET-CT were crucial in detecting extra-sinus and distant failures. Salvage surgery was feasible in the majority of patients (58.3%). Overall, 5 years survival (OS) rate was 60.9%.

Conclusions: Frequent clinic visits with nasal endoscopy combined with frequent imaging studies should be routinely practiced as part of a long-term surveillance plan. Longer follow up duration should be considered in these patients.

Keywords: imaging; nasal endoscopy; recurrence; sinonasal cancer; sinonasal malignancies; surveillance.

MeSH terms

  • Humans
  • Magnetic Resonance Imaging / methods
  • Neoplasm Recurrence, Local / epidemiology
  • Nose Neoplasms* / pathology
  • Paranasal Sinus Neoplasms* / diagnosis
  • Paranasal Sinus Neoplasms* / epidemiology
  • Paranasal Sinus Neoplasms* / therapy
  • Positron Emission Tomography Computed Tomography / methods
  • Retrospective Studies