Recurrence Patterns and Efficacy of Surveillance Modalities for Sinonasal Malignancies

Abstract

Objective There is limited information regarding the recurrence patterns and efficacy of surveillance modalities in patients with sinonasal malignancies. Methods A retrospective study was conducted between the years 2001–2018 at a tertiary care center. Included were all patients with sinonasal malignancies treated in our institution. Data regarding recurrence and survival were analyzed. Results Eighty-one patients were included. Multimodal treatment was administered to the majority of patients. 24 (35.3%) patients recurred with a median time of 17 months (range, 4–180). Although the majority of recurrences occurred within the first 5 years (83.3%), 4 (16.6%) recurred later on (5−15 years). Recurrences were local in 83.3%, regional in 20.8% and distant in 16.6%. All local recurrences occurred within the radiation treatment field and all patients with distant failure had mucosal melanoma. The majority of recurrences (70.6%) were diagnosed clinically or endoscopically, mainly in patients with SCC during the first 2 years of follow up. MRI or PET-CT were crucial in detecting extra-sinus and distant failures. Salvage surgery was feasible in the majority of patients (58.3%). Overall, 5 years survival (OS) rate was 60.9%. Conclusions Frequent clinic visits with nasal endoscopy combined with frequent imaging studies should be routinely practiced as part of a long-term surveillance plan. Longer follow up duration should be considered in these patients.