Prognostic factors in sinonasal cancers: A multicenter pooled analysis.

Abstract Poster

Authors

null

Alberto Hernando-Calvo

Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada

Alberto Hernando-Calvo , Milica Stefanovic , Shao Hui Huang , Jesús Brenes Castro , Jie Su , Brian O'Sullivan , Jolie Ringash , Alicia Lozano , Beatriz Cirauqui , Ezra Hahn , Iris Teruel , John R de Almeida , Jordi Marruecos , Ian Witterick , Jordi Rubió-Casadevall , David Paul Goldstein , Lillian L. Siu , John Waldron , Anna Spreafico , Marc Oliva

Organizations

Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, Department of Radiation Oncology. Institut Català d'Oncologia Hospitalet, Barcelona, Spain, Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada, Medical Oncology Department, Institut Català d’Oncologia Hospitalet, Barcelona, Spain, Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada, Department of Radiation Oncology. Institut Català d’Oncologia Hospitalet., Barcelona, Spain, Medical Oncology Department, Institut Català d'Oncologia Badalona, Barcelona, Spain, Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada, Medical Oncology Department, Institut Català d'Oncologia, Badalona, Spain, Princess Margaret Cancer Centre, Toronto, ON, Canada, Department of Radiation Oncology. Institut Català d'Oncologia Girona, Girona, Spain, Department of Otolaryngology-Head & Neck Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada, Medical Oncology Department, Institut Català d’Oncologia Girona, Girona, Spain, Department of Otolaryngology-Head & Neck Surgery, Princess Margaret Cancer Centre, Toronto, ON, Canada, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada, Phase 1/Drug Development Program, Catalan Institute of Oncology (ICO) L’Hospitalet, L´Hospitalet De Llobregat, Barcelona, Spain

Research Funding

No funding received

Background: Sinonasal cancers (SC) are heterogeneous diseases. Despite multimodality treatment, overall survival (OS) remains unsatisfactory. We aimed to identify prognostic factors (PFs) associated with patterns of failure and OS in non-metastatic SC (nmSC). Methods: We retrospectively reviewed a pooled dataset of nmSC from Princess Margaret (Canada) and Catalan Institute of Oncology (Spain) treated with definitive surgery ± postop radiotherapy (RT) or RT ± chemo according to institutional protocols between 2010-2019. In squamous cell carcinoma (SCC), HPV status was tested by p16 staining, and HPV DNA (ISH or PCR) if equivocal. The primary goal was to assess the association of tumor histology, stage (by 7th edition TNM), and other clinicopathological variables on locoregional control (LRC), distant control (DC) and OS. Actuarial rates were calculated with Kaplan–Meier (KM) method. Multivariable analysis (MVA) calculated hazard ratios (aHR) adjusted for histology type, T-/N-categories, and primary treatment. Results: Out of 342 pts, median age was 62 years (y) (range 21-96), Male:Female = 212:130, 95% had ECOG 0-1. Tumor histology types were: 192 (56%) SCC (p16+: 35; p16-/untested: 157), 40 (12%) adenocarcinoma (AD), 33 (10%) sinonasal undifferentiated carcinoma or sinonasal neuroendocrine tumors (SNUC/SNEC), 28 (8%) malignant melanoma (MM), 27 (8%) esthesioneuroblastoma (ES) and 22 (6%) adenoid cystic carcinoma (ACC). Median follow up was 3.6 y (range 0.1-11.3). Three-year actuarial rates for each endpoint are included in table. The PFs for LRC by MVA were: SNUC/SNEC (vs SCC) histology, T3-4 (vs T1-2: aHR 2.4, p = < 0.01) and N+ (vs N-: aHR 1.7, p = 0.02) diseases. The PFs for DC were: MM (vs SCC) and SNUC/SNEC (vs SCC) histology, and T3-4 (vs T1-2: aHR 6.0, p = 0.01) disease. The PFs for OS were: MM (vs SCC) histology, older age (aHR 1.0, p < 0.01), T3-4 (vs T1-2: aHR 5.6, p < 0.01), and N+ (vs N-: aHR 2.5, p < 0.01) disease. There was no difference in primary surgery vs RT in any outcome endpoint (all p > 0.05). p16+ SCC had a marginally higher LRC but similar DC and OS vs p16-/untested SCC (table). Conclusions: This large multicentre cohort of nmSC shows different patterns of relapse and survival with different tumor histologies. Our results suggest that individualization of treatment and follow-up strategies by histologic type is recommended to optimize outcomes in these orphan diseases.

3y OutcomeLRCaHRpDCaHRpOSaHRp
SCC67% (59-73)REF94% (89-97)REF68% (61-76)REF
AD69% (48-81)1.10.7289% (72-96)1.90.2774% (60-91)1.20.52
ACC82% (55-93)0.60.2191% (64-98)2.60.0667% (50-90)1.00.89
ES83% (58-93)0.70.4396% (69-99)0.60.6482% (67-100)0.60.29
MM64% (39-78)1.00.8542% (19-58)10.0< 0.0131% (17-56)2.00.01
SNUC/SNEC83% (61-93)0.40.0354% (30-69)8.0< 0.0159% (43-80)1.50.20
SCC
HPV-/untested64% (55-71)REF93% (88-96)REF66% (59-75)REF
HPV+79% (58-89)0.60.1697% (78-100)0.4 (univariable analysis)0.4075% (62-92)0.70.40

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Head and Neck Cancer

Track

Head and Neck Cancer

Sub Track

Other Head and Neck Cancer (Salivary, Thyroid)

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 6092)

DOI

10.1200/JCO.2022.40.16_suppl.6092

Abstract #

6092

Poster Bd #

83

Abstract Disclosures

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