Comparison of outcomes between patients with de‐novo sinonasal squamous cell carcinoma vs malignant transformations from inverted papillomas

Comparison of outcomes between patients with de‐novo sinonasal squamous cell carcinoma vs malignant transformations from inverted papillomas:

Background

The survival difference between de‐novo sinonasal squamous cell carcinoma (DN‐SNSCC) and SCC arising from inverted papillomas (IPs) is unclear. The purpose of this study was to compare the outcomes between DN‐SNSCC and IP‐transformed SNSCC (IP‐SNSCC) patients.

Methods

In this retrospective review, we compared IP‐SNSCC and DN‐SNSCC cases from the Eye and ENT Hospital of Fudan University from 2010 to 2017. A total of 162 patients (39 IP‐SNSCC and 123 DN‐SNSCC) were included in our study. Demographics, tumor characteristics, treatment, and clinical outcomes were analyzed.

Results

The median follow‐up time in all cohorts was 56 (range, 5‐109) months. There was no difference in age, sex, smoking history, alcohol consumption, tumor primary site, or disease stage between the IP‐SNSCC and DN‐SNSCC patients. We also did not find significant differences in overall survival and disease‐free survival between IP‐SNSCC and DN‐SNSCC patients (p = 0.584 and p = 0.238, respectively). The 5‐year local failure rate was 52.8% for IP‐SNSCC patients, which was significantly higher than for those with DN‐SNSCC (31.9%; p = 0.013). The 5‐year nodal failure rate was 19.0% for IP‐SNSCC patients and 8.5% for DN‐SNSCC patients (p = 0.211). The 5‐year distant metastasis rate was 8.0% for IP‐SNSCC patients and 16.1% for DN‐SNSCC patients (p = 0.318).

Conclusion

IP‐SNSCC and DN‐SNSCC patients have similar survival outcomes. IP‐SNSCC seems to have exhibited a higher local failure rate in our study. We believe that IP‐SNSCC is a highly aggressive disease that requires radical treatment. Prophylactic neck treatment should not be omitted in a subset of IP‐SNSCC patients.