Treatment outcomes and prognostic factors, including human papillomavirus, for sinonasal undifferentiated carcinoma: a retrospective review

Head Neck. 2015 Mar;37(3):366-74. doi: 10.1002/hed.23606. Epub 2014 Apr 30.


Background: Sinonasal undifferentiated carcinoma (SNUC) is a high-grade, aggressive neoplasm. Low incidence and poor outcomes make identification of prognostic factors and treatment standardization difficult. Similarly, little is known regarding the association of human papillomavirus (HPV) with SNUC.

Methods: A retrospective review was conducted. Extracted information included treatment received, tumor recurrence, patient survival, p16 expression, and HPV status. The Kaplan-Meier method was used to estimate overall survival (OS) and disease-free survival (DFS). Survival trends were compared using the log-rank test.

Results: Nineteen patients received multimodality treatment for SNUC. Five-year OS and DFS rates were 45.2% and 50.7%, respectively, with no significant difference between treatment types. Tumors from 11 patients were p16-positive and 9 of these were also HPV-positive. Kaplan-Meier analysis demonstrated improved survival.

Conclusion: Our series demonstrates a higher prevalence of HPV in SNUC than previously reported. HPV-positive SNUCs may benefit from improved survival and should be investigated further in future studies.

Keywords: human papillomavirus; p16; sinonasal malignancy; sinonasal undifferentiated carcinoma; treatment.

MeSH terms

  • Adult
  • Aged
  • Carcinoma / mortality*
  • Carcinoma / pathology
  • Carcinoma / therapy*
  • Carcinoma / virology
  • Cohort Studies
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Maxillary Sinus Neoplasms / mortality*
  • Maxillary Sinus Neoplasms / pathology
  • Maxillary Sinus Neoplasms / therapy*
  • Maxillary Sinus Neoplasms / virology
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / therapy
  • Paranasal Sinus Neoplasms / mortality
  • Paranasal Sinus Neoplasms / pathology
  • Paranasal Sinus Neoplasms / therapy*
  • Paranasal Sinus Neoplasms / virology
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Time Factors
  • Treatment Outcome

Supplementary concepts

  • Sinonasal undifferentiated carcinoma