Survival rates and prognostic factors of 118 sinonasal sarcomas among adolescents and adults: a national database REFCOR study

Charles-Henri Hassan; Mélodie Kérimian; Caroline Even; Antoine Moya-Plana; Benjamin Verillaud; Olivier Malard; Justin Michel; Valentin Favier; Geoffrey Mortuaire; Sylvain Morinière; Bertrand Baujat; Cécile Rumeau; Sebastien Vergez; Christian Righini; Vincent Patron; Charles Dupin; Adam Loffler; Antoine Bénard; Laurence Digue; Juliette Thariat; Ludovic de Gabory

doi:10.1016/j.ejso.2025.110247

Survival rates and prognostic factors of 118 sinonasal sarcomas among adolescents and adults: a national database REFCOR study

Eur J Surg Oncol. 2025 Sep;51(9):110247. doi: 10.1016/j.ejso.2025.110247. Epub 2025 Jun 21.

Authors

Charles-Henri Hassan¹, Mélodie Kérimian², Caroline Even³, Antoine Moya-Plana³, Benjamin Verillaud⁴, Olivier Malard⁵, Justin Michel⁶, Valentin Favier⁷, Geoffrey Mortuaire⁸, Sylvain Morinière⁹, Bertrand Baujat¹⁰, Cécile Rumeau¹¹, Sebastien Vergez¹², Christian Righini¹³, Vincent Patron¹⁴, Charles Dupin¹⁵, Adam Loffler¹⁶, Antoine Bénard¹⁶, Laurence Digue¹⁷, Juliette Thariat¹⁸, Ludovic de Gabory¹⁹

Affiliations

¹ Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, France; Univ. Bordeaux, 33000, France.
² Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, France.
³ Department of Otorhinolaryngology - Head and Neck Surgery, Gustave Roussy Cancer Center, Villejuif, France.
⁴ Department of Otorhinolaryngology - Head and Neck Surgery, Lariboisière University Hospital, Paris, France.
⁵ Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Nantes, Nantes, France.
⁶ Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Marseille, AP-HM Marseille, France.
⁷ Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France.
⁸ Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Lille, Lille, France.
⁹ Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Tours, Tours, France.
¹⁰ Department of Otolaryngology-Head and Neck Surgery, Hopital Tenon, AP-HP, Sorbonne University, 75020, Paris, France.
¹¹ Department of Otorhinolaryngology, Université de Lorraine, CHRU Nancy, Service ORL, F-54000, Nancy, France.
¹² Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Toulouse, Toulouse, France.
¹³ Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Grenoble, Grenoble, France.
¹⁴ Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Caen, Caen, France.
¹⁵ Department of Oncology and Radiotherapy, Hôpital Haut-Lévêque, University Hospital of Bordeaux, avenue Magellan, Pessac, 33600, France.
¹⁶ Pôle de Santé Publique, Clinical Epidemiology Unit (USMR), F-33000, Bordeaux, France.
¹⁷ Department of Medical Oncology, University Hospital of Bordeaux, Bordeaux, France.
¹⁸ Comprehensive Cancer Centre Francois Baclesse, Department of Radiation Oncology, 3, avenue du Général Harris, 14000, Caen, France.
¹⁹ Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, France; Univ. Bordeaux, 33000, France. Electronic address: ludovic.de-gabory@chu-bordeaux.fr.

PMID: 40623344
DOI: 10.1016/j.ejso.2025.110247

Abstract

Introduction: Sinonasal sarcomas are a heterogeneous group of rare tumors that are poorly documented and whose prognostic factors are not clearly established.

Material and methods: This was a retrospective multicenter observational study using the national REFCOR database to analyze the characteristics, management and prognostic factors of patients with sinonasal sarcomas among adolescents and adults. Overall survival and disease-free survival were assessed. The influence of age, gender, TNM classification, histological subtype, grade and treatment modality was calculated using Log-Rank tests and Cox proportional hazard models for multivariate analyses.

Results: 118 cases of sinonasal sarcomas were analyzed between 2010 and 2020. Median age was 50 years. Four histological subtypes predominated: rhabdomyosarcoma (21.2 %), chondrosarcoma (19.5 %), osteosarcoma (14.4 %) and biphenotypic sarcoma (9.3 %). Overall survival rates at 1, 3 and 5 years were respectively 99 %, 81.2 % and 68.8 %, and disease-free survival rates 96 %, 73.5 % and 58.3 %. Overall and disease-free survival of sinonasal sarcomas were significantly different by age (p < 0.001), gender (p < 0.001), histological subtype (p = 0.00062, with rhabdomyosarcomas and biphenotypic sarcomas being the most and least aggressive types, respectively), lymph node status (p = 0.05 and p < 0.0001), metastatic status (p = 0.004 and p < 10^-4), multimodal treatment protocol (p < 10^-4) including surgical resection (p < 10^-4). Surgery by endoscopic endonasal approaches yielded similar or better outcomes compared to open surgery.

Conclusion: Age, histological subtype, N+ and M+ status at diagnosis and therapeutic management influenced survival in sinonasal sarcomas. Survival rates varied widely according to histological subtype, and not all sarcomas have a poor prognosis.

Keywords: Endonasal endoscopic surgery; Paranasal cancer; REFCOR; Sarcoma; Sinonasal cancer.

Publication types

Multicenter Study
Observational Study

MeSH terms

Adolescent
Adult
Age Factors
Aged
Chondrosarcoma / mortality
Chondrosarcoma / pathology
Chondrosarcoma / therapy
Databases, Factual
Disease-Free Survival
Female
Humans
Male
Middle Aged
Neoplasm Staging
Osteosarcoma / mortality
Osteosarcoma / pathology
Osteosarcoma / therapy
Paranasal Sinus Neoplasms* / mortality
Paranasal Sinus Neoplasms* / pathology
Paranasal Sinus Neoplasms* / therapy
Prognosis
Proportional Hazards Models
Retrospective Studies
Rhabdomyosarcoma / mortality
Rhabdomyosarcoma / pathology
Rhabdomyosarcoma / therapy
Sarcoma* / mortality
Sarcoma* / pathology
Sarcoma* / therapy
Survival Rate
Young Adult