Risk Factors in Short Term Mortality in Sinonasal Squamous Cell Carcinoma: A Review of the National Cancer Database

Background: Sinonasal squamous cell carcinomas (SCC) are rare with a limited number of cases in our literature previously described from single institution studies. This study utilized the National Cancer Database (NCDB) to evaluate outcomes of sinonasal SCC in a 10-year period (2004–2013).

Methods: The NCDB dataset was queried for patients with diagnosis codes consistent with SCC from the nasal cavity and paranasal sinuses. Univariate and multivariate bidirectional stepwise regression analyses were performed to identify factors contributing to the primary outcomes of 30-day and 90-day mortality.

Results: 5898 patients met inclusion criteria with a mean age of 65.2 years at diagnosis and 64% male. 50% of patients were treated at academic or research centers. The most common subsite involved was the nasal cavity (47.2%) followed by the maxillary sinus (38.6%). The overall mortality rate at 30 days and 90 days were 0.8% and 3.4%, respectively. Advanced age had a negative effect for both 30 (p < 0.001) and 90-day mortality (p < 0.001). When compared with the nasal cavity, SCC arising from the maxillary (OR 3.31, 95% CI 2.09–5.37, p < 0.0001), ethmoid (OR 4.75, 95% CI 2.26–9.46, p < 0.0001), and sphenoid sinuses (OR 3.82, 95% CI 0.88–11.7, p < 0.05) are negative prognostic factors for 90-day mortality. Frontal sinus as a tumor subsite was not an independent prognostic factor of mortality; however analysis was limited by only 83 cases of frontal sinus SCC.

Conclusions: SCC of the sinonasal cavity remains an aggressive pathology leading to high mortality rates even in the short term. Age and tumor location appear to play a role in patient survival outcome, as other subsites besides the nasal cavity are negative prognostic factors in 90 day-mortality.