Adenocarcinoma of the Sinonasal Tract: A Review of the National Cancer Database

Objectives Adenocarcinoma of the sinonasal tract is a rare malignancy arising from mucus-secreting glandular tissue. Limited large-scale studies are available due to its rarity. This study describes the incidence and determinants of survival of patients with sinonasal adenocarcinoma between the years of 2004 and 2012 using the National Cancer Database (NCDB).

Design Retrospective, population-based cohort study.

Setting Tertiary academic medical center.

Participants Patients who were diagnosed with sinonasal adenocarcinoma between 2004 and 2012 within the NCDB.

Main Outcome Measures Overall survival (OS).

Results A total of 553 patients were identified. The cohort was composed of 59.3% males. Mean age at diagnosis was 61.8 years. The nasal cavity was the most common primary site, accounting for 44.1% of cases. 5.7% of patients presented with nodal disease, while 3.3% had distant metastases. 40.6% of cases presented with stage IV disease. 73.5% of patients underwent surgery, 54.2% received radiation therapy, and 27.7% had chemotherapy. Median OS was 71.7 months, while OS at 1, 2, and 5 years was 82, 73.0, and 52%, respectively. On multivariate analysis, advanced age (p < 0.001), Charlson's comorbidity index > 0 (p = 0.008), advanced tumor grade (p = 0.015), and advanced tumor stage (p < 0.001) were associated with worse OS, whereas surgery (p < 0.001) and radiation therapy (p = 0.020), but not chemotherapy (p = 0.635), predicted improved OS.

Conclusion Sinonasal adenocarcinoma is a rare primary malignancy with 5-year survival approximating 50%. A significant proportion of patients present with advanced disease. Surgery and radiation therapy, but not chemotherapy, are associated with improved survival, and likely play a critical role in the interdisciplinary management of this disease.