Multimodality therapy including surgery improves survival in sinonasal squamous cell carcinoma: Study
Recent research has found out that multimodality therapy, including surgical intervention, associates with improved overall survival (OS) after multifactorial adjustments and that induction chemotherapy (IC) followed by surgery associated with improved OS compared to induction chemotherapy (IC), followed by chemoradiation therapy (CRT) and CRT alone.
The study is published in the International Forum of Allergy and Rhinology.
Sinonasal squamous cell carcinoma (SNSCC) is a rare malignancy that poses management challenges. Although surgery and chemoradiation therapy (CRT) remain therapeutic mainstays, induction chemotherapy (IC) has emerged as a useful adjunct with locally advanced disease.
Hence, Nyssa Fox Farrell and colleagues from the Department of Otolaryngology–Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Oregon Health and Science University, Portland, OR used the National Cancer Data Base (NCDB) to examine treatment outcomes for patients diagnosed with SNSCC.
The NCDB was queried for cases with SNSCC. Multivariate hazard regression modeling was used to identify significant predictors of 24-month and 60-month overall survival (OS) including treatment modality.
The following findings were seen-
- A total of 3516 patients with SNSCC met inclusion criteria, including 1750 patients (49.8%) treated with surgery ± adjuvant therapy, 1352 (38.5%) treated with definitive radiotherapy (RT) or CRT, 300 (8.5%) who underwent IC followed by definitive CRT, and 114 (3.2%) who received IC followed by surgery and adjuvant therapy.
- Hazard modeling for confirmed treatment modality significantly associated (p < 0.001) with OS after adjustment.
- Patients who received surgical intervention ± adjuvant therapy had lower 24-month and 60-month mortality risk compared to definitive RT or CRT (hazard ratio [HR] ≥ 1.97; p < 0.001) or IC followed by definitive CRT (HR ≥ 1.73; p < 0.001).
- Compared to primary surgery ± adjuvant therapy, patients undergoing IC then surgery had similar 24-month and 60-month OS (p ≥ 0.672) after adjustment.
Therefore, the authors concluded that "multimodality therapy, including surgical intervention, associates with improved OS after multifactorial adjustments. IC followed by surgery associated with improved OS compared to IC, followed by CRT and CRT alone. Study results highlight the utility of surgery toward optimizing OS in patients with SNSCC and demonstrates the potential utility of IC when primary surgical management is not preferred."