Elective neck treatment in sinonasal undifferentiated carcinoma: Systematic review and meta-analysis

Head Neck. 2020 May;42(5):1057-1066. doi: 10.1002/hed.26077. Epub 2020 Jan 10.

Abstract

Sinonasal undifferentiated carcinomas (SNUCs), being an aggressive malignancy with dismal survival outcome, have given limited consideration regarding management of regional failures. A total of 12 studies, published between 1999 and 2019, met inclusion criteria. We performed a meta-analysis assessing regional (neck) relapse after elective neck treatment compared to observation in clinically node negative (N0) necks. Clinical data of 255 patients were used for meta-analysis. Among them, 83.4% of patients presented with T4 tumors and 14.1% had positive neck nodes. Elective neck treatment was applied in 49.5% of analyzed patients. Regional relapses occurred in 3.7% of patients who have undergone elective neck treatment compared to 26.4% in patients who had not. Elective neck treatment significantly reduced the risk of regional recurrence (odds ratio 0.20; 95% confidence interval 0.08-0.49; P = .0004). The meta-analysis indicates that elective neck treatment could significantly reduce the risk of regional failures in patients with SNUCs.

Keywords: SNUC; elective neck dissection; elective neck treatment; regional relapse; sinonasal undifferentiated carcinoma.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Carcinoma
  • Carcinoma, Squamous Cell* / pathology
  • Elective Surgical Procedures
  • Humans
  • Maxillary Sinus Neoplasms*
  • Neck Dissection
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Retrospective Studies

Supplementary concepts

  • Sinonasal undifferentiated carcinoma