TY - JOUR
T1 - Meta-analysis of 701 published cases of sinonasal neuroendocrine carcinoma
T2 - The importance of differentiation grade in determining treatment strategy
AU - van der Laan, Tom P.
AU - Iepsma, Rene
AU - Witjes, Max J. H.
AU - van der Laan, Bernard F. A. M.
AU - Plaat, Boudewijn E. C.
AU - Halmos, Gyorgy B.
PY - 2016/12
Y1 - 2016/12
N2 - The aim of this meta-analysis was to provide treatment guidelines for sinonasal neuroendocrine carcinoma (SNC) by combining all available data in the literature.A literature search for all studies concerning SNC was performed against the MEDLINE and EMBASE databases. Available clinical data was normalized, pooled, and statistically analyzed.A total of 701 cases of SNC were available for analysis, comprising 127 well or moderately differentiated sinonasal neuroendocrine carcinomas (SNEC), 459 sinonasal undifferentiated carcinoma (SNUC) and 115 sinonasal small cell carcinoma (SmCC). Tumor type was the most important predictor of survival, with a 5-year disease-specific survival (DSS) of 70.2% for SNEC, 35.9% for SNUC and 46.1% for SmCC. Tumor stage on presentation was of limited value in predicting survival or response to treatment. Overall, the application of surgery yielded significantly better results (5-year DSS 52.2% versus 30.1%, p <0.001). In SNUC, radiotherapy was a beneficial supplement to surgery (5-year DSS 54.7% versus 15.7%, p = 0.027), while radiotherapy as monotherapy performed poorly (5-year DSS 17.9%). Chemotherapy did not appear to contribute to survival.Based on these findings, we can conclude that the most important predictors of survival in SNC are differentiation grade and the associated choice of treatment modality. In contrast to other head and neck cancers, tumor staging appears of limited value in predicting survival or deciding on a treatment strategy. Surgery should be the cornerstone of treatment, supplemented by radiotherapy in poorly differentiated subtypes (SNUC, SmCC). Chemotherapy does not appear to contribute to survival. (C) 2016 The Authors. Published by Elsevier Ltd.
AB - The aim of this meta-analysis was to provide treatment guidelines for sinonasal neuroendocrine carcinoma (SNC) by combining all available data in the literature.A literature search for all studies concerning SNC was performed against the MEDLINE and EMBASE databases. Available clinical data was normalized, pooled, and statistically analyzed.A total of 701 cases of SNC were available for analysis, comprising 127 well or moderately differentiated sinonasal neuroendocrine carcinomas (SNEC), 459 sinonasal undifferentiated carcinoma (SNUC) and 115 sinonasal small cell carcinoma (SmCC). Tumor type was the most important predictor of survival, with a 5-year disease-specific survival (DSS) of 70.2% for SNEC, 35.9% for SNUC and 46.1% for SmCC. Tumor stage on presentation was of limited value in predicting survival or response to treatment. Overall, the application of surgery yielded significantly better results (5-year DSS 52.2% versus 30.1%, p <0.001). In SNUC, radiotherapy was a beneficial supplement to surgery (5-year DSS 54.7% versus 15.7%, p = 0.027), while radiotherapy as monotherapy performed poorly (5-year DSS 17.9%). Chemotherapy did not appear to contribute to survival.Based on these findings, we can conclude that the most important predictors of survival in SNC are differentiation grade and the associated choice of treatment modality. In contrast to other head and neck cancers, tumor staging appears of limited value in predicting survival or deciding on a treatment strategy. Surgery should be the cornerstone of treatment, supplemented by radiotherapy in poorly differentiated subtypes (SNUC, SmCC). Chemotherapy does not appear to contribute to survival. (C) 2016 The Authors. Published by Elsevier Ltd.
KW - Head and neck cancer
KW - Meta-analysis
KW - Neuroendocrine carcinoma
KW - Paranasal sinuses
KW - Nasal cavity
KW - Sinonasal undifferentiated carcinoma
KW - Small cell carcinoma
KW - SMALL-CELL-CARCINOMA
KW - OF-THE-LITERATURE
KW - ANTIDIURETIC-HORMONE SECRETION
KW - PARA-NASAL SINUSES
KW - SINGLE-INSTITUTION EXPERIENCE
KW - UNDIFFERENTIATED CARCINOMA
KW - MAXILLARY SINUS
KW - PARANASAL SINUSES
KW - CASE SERIES
KW - OLFACTORY NEUROBLASTOMA
U2 - 10.1016/j.oraloncology.2016.10.002
DO - 10.1016/j.oraloncology.2016.10.002
M3 - Review article
C2 - 27938993
SN - 1368-8375
VL - 63
SP - 1
EP - 9
JO - Oral Oncology
JF - Oral Oncology
ER -