Prognostic Factors and Outcomes of De Novo Sinonasal Squamous Cell Carcinoma: A Systematic Review and Meta-analysis

Otolaryngol Head Neck Surg. 2022 Mar;166(3):434-443. doi: 10.1177/01945998211021023. Epub 2021 Jul 13.

Abstract

Objective: To review overall survival (OS), recurrence patterns, and prognostic factors of de novo sinonasal squamous cell carcinoma (DN-SCC).

Data sources: PubMed, Scopus, OVID Medline, and Cochrane databases from 2006 to December 23, 2020.

Review methods: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Articles were required to report either recurrence patterns or survival outcomes of adults with DN-SCC. Case reports, books, reviews, meta-analyses, and database studies were all excluded.

Results: Forty-one studies reported on survival or recurrence outcomes. The aggregate 5-year OS was 54.5% (range, 18%-75%) from 35 studies (n = 1903). Patients undergoing open surgery were more likely to receive radiation therapy and present at an advanced stage compared to those receiving endoscopic surgery (all P < .001). Advanced T stage, presence of cervical nodal metastases, maxillary sinus primary site, and negative human papillomavirus (HPV) status were all correlated with significantly worse 5-year OS. Direct meta-analysis of 8 studies demonstrated patients with surgery were more likely to be alive at 5 years compared to those who did not receive surgery (odds ratio, 2.26; 95% CI, 1.48-3.47; P < .001). Recurrence was reported in 628 of 1471 patients from 26 studies (42.7%) with an aggregate 5-year locoregional control rate of 67.1% (range, 50.4%-93.3%).

Conclusion: This systematic review and meta-analysis suggests that the 5-year OS rate for DN-SCC may approach 54.5% and recurrence rate approaches 42.7%. In addition, various tumor characteristics including advanced T stage, positive nodal status, maxillary sinus origin, and negative HPV status are all associated with decreased survival.

Keywords: endoscopic surgery; open surgery; sinonasal cancer; sinuses.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Alphapapillomavirus*
  • Carcinoma*
  • Humans
  • Papillomaviridae
  • Papillomavirus Infections*
  • Paranasal Sinus Neoplasms* / surgery
  • Prognosis
  • Squamous Cell Carcinoma of Head and Neck