Outcome by treatment modality in sinonasal undifferentiated carcinoma (SNUC): A case-series, systematic review and meta-analysis.

Morand, Grégoire B; Anderegg, Nanina; Vital, Domenic; Ikenberg, Kristian; Huber, Gerhard F; Soyka, Michael B; Egger, Matthias; Holzmann, David (2017). Outcome by treatment modality in sinonasal undifferentiated carcinoma (SNUC): A case-series, systematic review and meta-analysis. Oral oncology, 75, pp. 28-34. Elsevier 10.1016/j.oraloncology.2017.10.008

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OBJECTIVE Sinonasal undifferentiated carcinoma (SNUC) is an aggressive malignancy first described by Frierson et al. in 1986. As the tumor is very rare, current treatment recommendations are based on institutional case reports. We thus felt the need to perform a comprehensive systematic review and meta-analysis to investigate how treatment modalities are associated with survival. DESIGN Case-series, systematic review and meta-analysis METHODS: We searched the OvidMedline, OvidEmbase, Web of Science, Biosis, Scopus and the Cochrane Library database libraries. We extracted aggregate and individual patient data for statistical analysis. To study the association between treatment modalities and survival, we used random-effects meta-regression for the aggregate- and cox mixed-effects models. RESULTS 379 citations were found; 29 case series could be included in the final analysis, including a total number of 390 single patients (34.6% female). Median age at diagnosis was 52 years. 80.9% of patients presented with a T4 tumor and 16.0% with nodal metastasis at diagnosis. In individual patient data (IPD) meta-analysis, single modality (surgery alone or radiation alone) treatment was associated with reduced survival compared to double modality (surgery & radiation or chemoradiation) treatment (adjusted Hazard Ratio [aHR] 2.97, 95% ConfidenceInterval [1.41-6.27]) and compared to triple modality (surgery & radiation & chemotherapy) treatment (aHR 2.80 95%-CI 1.29-6.05 for triple vs. single modality). Triple modality treatment was not superior to double modality treatment. (aHR 1.06, 95%-CI 0.59-1.92). CONCLUSION Double and triple modality treatment are associated with improved survival over single modality but there is no evidence that triple modality is superior to double modality treatment.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Anderegg, Nanina Tamar and Egger, Matthias

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1368-8375

Publisher:

Elsevier

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

11 Jan 2018 11:54

Last Modified:

22 Jan 2018 09:09

Publisher DOI:

10.1016/j.oraloncology.2017.10.008

PubMed ID:

29224819

Uncontrolled Keywords:

Chemoradiotherapy Nose neoplasms Sinonasal undifferentiated carcinoma Skull base Surgery

BORIS DOI:

10.7892/boris.108652

URI:

https://boris.unibe.ch/id/eprint/108652

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