J Neurol Surg B Skull Base 2020; 81(S 01): S1-S272
DOI: 10.1055/s-0040-1702489
Oral Presentations
Georg Thieme Verlag KG Stuttgart · New York

The Impact of Induction Chemotherapy and Socioeconomic Factors on Survival in Sinonasal Undifferentiated Carcinoma

Khodayar Goshtasbi
1   Department of Otolaryngology - Head and Neck Surgery, University of California Irvine, Irvine, California, United States
,
Brandon M. Lehrich
2   University of California Irvine, Irvine, California, United States
,
Arash Abiri
1   Department of Otolaryngology - Head and Neck Surgery, University of California Irvine, Irvine, California, United States
,
Tyler Yasaka
2   University of California Irvine, Irvine, California, United States
,
Frank P. Hsu
3   Department of Neurological Surgery, University of California Irvine, Irvine, California, United States
,
Gilbert Cadena
3   Department of Neurological Surgery, University of California Irvine, Irvine, California, United States
,
Edward C. Kuan
1   Department of Otolaryngology - Head and Neck Surgery, University of California Irvine, Irvine, California, United States
› Author Affiliations
Further Information

Publication History

Publication Date:
05 February 2020 (online)

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Introduction: Sinonasal undifferentiated carcinoma (SNUC) is a rare and aggressive malignancy of the sinonasal cavity. The role of induction chemotherapy (IC) and demographic or socioeconomic factors on overall survival (OS) of patients with SNUC is yet to be determined.

Methods: The National Cancer Database (NCDB) was queried for all patients diagnosed with histologically confirmed SNUC from 2004 to 2015. IC was defined as chemotherapy administered 6 months to 2 weeks before surgery or ≥45 days prior to radiotherapy.

Results: Of 440 patients with a diagnosis of SNUC, 70 (16%) underwent treatments involving IC. This consisted of 52 (12%) patients receiving IC before definitive radiation therapy without surgery, 15 (3%) receiving IC before surgery and adjuvant radiotherapy, and 3 (1%) receiving IC before surgery only. On univariate analysis, patients with primary site location in the paranasal sinuses (HR: 1.37; 95% CI: 1.04–1.79; p = 0.02), having government insurance (HR: 1.79; 95% CI: 1.37–2.34; p < 0.001), and living in regions with ≥ 13% of the population without a high school diploma (HR: 1.38; 95% CI: 1.06–1.79; p = 0.02) were associated with worse OS. On log-rank test, patients with advanced stage had similar OS regardless of receiving IC or not (p = 0.96). Patients who received IC lived closer to their treatment site (p = 0.02). Additionally, on logistic regression, patients with a lower Charlson–Deyo comorbidity score, a measure of overall health and existence of comorbidities, were more likely to receive IC (p = 0.04). The timing of IC prior to definitive surgery or radiation did not affect OS (p = 0.69).

Conclusion: IC did not seem to provide additional survival benefit to patients with SNUC regardless of disease stage or timing prior to definitive treatment. Having government insurance and residing in less educated regions may impact OS for patients with SNUC.