Sinonasal Undifferentiated Carcinoma: A 15-Year Single-Institution Experience

Introduction: Sinonasal Undifferentiated Carcinoma (SNUC) is an aggressive neoplasm, with conflicting existing literature regarding prognosis and treatment due to the rarity of disease. Characterization of optimal SNUC management is necessary for improved outcomes.

Methods: Patients with pathologically confirmed SNUC treated within the 15-year period from 1991 to 2015 at the Hospital of the University of Pennsylvania were identified, and records were obtained and evaluated for several demographic characteristics. Overall survival from diagnosis was the primary endpoint, while disease recurrence and presence of distant metastases were secondary endpoints of the study.

Results: Twenty-seven patients with established SNUC were included in this cohort, with a median age of 55 years. 85% of patients were surgically treated, and 85% of patients presented with stage IV disease. 2-year overall survival was 64% and 5-year overall survival was 40%. 96% of patients received both chemotherapy and radiation as adjuvant treatment. Stage IVC disease, distant metastases, and disease recurrence all significantly decreased patient survival (p < 0.01).

Conclusion: This is an analysis of a single-institution SNUC cohort, consisting of 27 SNUC patients treated within a 15-year period. The majority of patients at this institution presented with clinically advanced disease, and most were managed with a multimodality approach of surgical resection, chemotherapy, and radiation. Extent of disease at presentation and progression of disease following treatment are poor prognostic signs and may merit a more aggressive approach, while early detection and treatment appear to improve survival and decrease patient morbidity.