Impact of induction chemotherapy and socioeconomics on sinonasal undifferentiated carcinoma survival - PubMed (original) (raw)

. 2020 May;10(5):679-688.

doi: 10.1002/alr.22536. Epub 2020 Feb 27.

Affiliations

Impact of induction chemotherapy and socioeconomics on sinonasal undifferentiated carcinoma survival

Brandon M Lehrich et al. Int Forum Allergy Rhinol. 2020 May.

Abstract

Background: Sinonasal undifferentiated carcinoma (SNUC) is an uncommon malignancy of the nasal cavity and accessory sinuses with limited available studies evaluating role of induction chemotherapy (IC), demographics, and socioeconomic factors on overall survival (OS).

Methods: The 2004-2015 National Cancer Database was queried for patients with histologically confirmed SNUC. IC was defined as chemotherapy administered 6 months to 2 weeks before surgery or ≥45 days before radiotherapy.

Results: Of 440 identified patients, 70 (16%) underwent treatments involving IC. This consisted of 52 (12%), 15 (3%), and 3 (1%) patients receiving IC before definitive radiation therapy, surgery and adjuvant radiotherapy, or surgery only, respectively. On univariate analysis, IC (p = 0.34) did not affect OS, whereas having government insurance (hazard ratio [HR], 1.79; 95% confidence interval [CI], 1.37-2.34; p < 0.001) and living in regions with ≥13% of the population without a high school diploma (HR, 1.38; 95% CI, 1.06-1.79; p = 0.02) were associated with worse OS. On log-rank test, patients with advanced stage had similar OS regardless of whether or not they received IC (p = 0.96). Patients who received IC lived closer to their treatment site (p = 0.02) and had worse overall health, with more comorbidities (p = 0.02). The timing of IC before definitive surgery or radiation did not affect OS (p = 0.69).

Conclusion: In this SNUC population-based analysis, IC did not appear to provide additional OS benefit regardless of disease stage or timing before definitive treatment. Distance to treatment and level of comorbidities may be associated with receiving IC, whereas type of insurance and residence education level may impact SNUC OS, regardless of treatment.

Keywords: NCDB; induction chemotherapy; outcome; sinonasal undifferentiated carcinoma; survival.

© 2020 ARS-AAOA, LLC.

PubMed Disclaimer

References

    1. Chambers KJ, Lehmann AE, Remenschneider A, et al. Incidence and survival patterns of sinonasal undifferentiated carcinoma in the United States. J Neurol Surg B Skull Base. 2015;76:94-100.
    1. Ejaz A, Wenig BM. Sinonasal undifferentiated carcinoma: clinical and pathologic features and a discussion on classification, cellular differentiation, and differential diagnosis. Adv Anat Pathol. 2005;12:134-143.
    1. Mendenhall WM, Mendenhall CM, Riggs CE Jr, Villaret DB, Mendenhall NP. Sinonasal undifferentiated carcinoma. Am J Clin Oncol. 2006;29:27-31.
    1. Workman AD, Brody RM, Kuan EC, et al. Sinonasal undifferentiated carcinoma: a 15-year single institution experience. J Neurol Surg B Skull Base. 2019;80:88-95.
    1. Kuan EC, Arshi A, Mallen-St Clair J, Tajudeen BA, Abemayor E, St John MA. Significance of tumor stage in sinonasal undifferentiated carcinoma survival: a population-based analysis. Otolaryngol Head Neck Surg. 2016;154:667-673.

MeSH terms

Supplementary concepts

LinkOut - more resources