Elective Neck Dissection in Stage I and II Sinonasal Squamous Cell Carcinomas : A European Head and Neck Cancer Center Survey Study

Background Occult metastases has been described in 5-20 % of sinonasal squamous cell carcinomas, but elective neck treatment is rarely performed in stage I and stage II tumors. The aim of the study was to evaluate whether elective neck dissection (END) in early stage sinonasal carcinomas is a part of management in Head and Neck Cancer Centers in Europe.

Methods A questionnaire regarding indications and extent of END in stage I and II carcinomas, with particular emphasis on different anatomic subsites (lateral wall, nasal septum, and paranasal sinuses), was sent to 38 European Head and Neck Cancer Centers. Data of 20 (52.6 %) centers (Austria: n = 9; Germany: n = 9; Switzerland: n = 1; Great Britain; n = 1) were returned and available for analysis.

Results The percentages of respondents who do not perform END for stage I carcinomas of lateral nasal wall, nasal wall septum and paransal sinuses were 90, 95 and 95 respectively. Similarly, END was not recommended from 70 %, 80 % and 80 % of centers for stage II tumors of lateral nasal wall, nasal septum and paranasal sinuses, respectively.

Conclusion Despite occult metastasis and regional recurrences along with dismal prognosis, END has been routinely performed in only one Head and Neck Center. Still to date, multicentric, prospective studies are warranted to determine the impact of END on oncological outcome in stage I and II sinonasal SCC and subsequently to change clinical management for this rare tumor entity.

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Publication History

Article published online:
10 June 2020