Management of 80 Sinonasal Undifferentiated Carcinomas. Retrospective multicentre study of the French Network of Rare Head and Neck Cancers (REFCOR)

Objectives: Sinonasal undifferentiated carcinoma (SNUC) is a rare and aggressive disease requiring multimodal treatment, and multiple new entities once included in the spectrum of SNUC, such as SWI/SNF-deficient carcinomas, are emerging. We aimed to provide new data regarding the role of chemotherapy and surgery and the prognostic factors of disease-free survival. Methods: This study was based on data from the REFCOR database and included patients with SNUC treated with curative intent from 2007 to 2021 across 22 centres in France. We collected data on treatments, histologic and oncologic outcomes, toxicities and prognostic factors. Results: A total of 80 patients were included in the analysis. Among the entire cohort, the 5-year progression-free survival (PFS) and overall survival (OS) rates were 58% and 63%, respectively. Approximately 100% of the patients were treated with irradiation, 29% with surgery, 56% with neoadjuvant chemotherapy (82% had either a partial or a complete response) and 76% with chemoradiotherapy. No treatment modality was associated with a better OS or PFS, including surgery (p=0.34). There was a trend for a better PFS for the patients treated with chemotherapy (neoadjuvant or concurrent, p=0.062). The patients with SWI/SNF-deficient carcinomas had a significantly worse PFS (p=0.021) and OS (p=0.03) than the rest of the population. Conclusion: In the management of localised SNUC among all patients treated with irradiation, surgery yielded no benefit, whereas the addition of chemotherapy tended to improve disease-free survival. (author)