Many concepts for few cases – which way is the right one to proceed in the treatment of SNUC?

Introduction Sinonasal undifferentiated carcinoma (SNUC) is a very rare disease. Due to lack of randomized control trials, guidelines are based on small case series. The purpose of this study was to analyze SNUC cases of the past ten years with regard to therapy, overall survival, and disease-free survival and to perform a systematic literature research.

Methods We retrospectively searched our patient management system for the period from 01.01.2011 to 31.12.2021 using the relevant ICD-10 diagnostic codes and filtered the results for patients with SNUC. Each case was then investigated in detail. Survival analysis was performed comparing multi modal treatment vs. single modality. Results were compared to historic cohorts in the literature of the past years.

Results We identified 9 patients of SNUC. Five patients were still alive at least 1.5 years after diagnosis. All of them received surgical treatment, four underwent adjuvant therapy. Four patients died, of which one declined any therapy, one received primary chemoradiotherapy, and two received surgery with adjuvant therapy. Survival analysis showed a non-significant advantage of multi modal treatment compared to single modality for overall and disease-free survival. The results were compared to the outcomes of the identified studies.

Conclusion In this series of 9 patients with SNUC we followed a multimodal therapy approach, if possible, with surgery as main stage. According to our experience a surgical approach should be pursued even in advanced stage diseases. In recent retrospective studies, induction chemotherapy showed promising results, however, larger, randomized studies are needed to determine therapy sequence.

Publication History

Article published online:
12 May 2023