1102P - Sinonasal non glandular cancers relapsing after multimodal treatments

Date 10 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Cancer in Adolescents
Head and Neck Cancers
Presenter Stefano Cavalieri
Citation Annals of Oncology (2017) 28 (suppl_5): v372-v394. 10.1093/annonc/mdx374
Authors S. Cavalieri1, R. Granata1, L.D. Locati1, C. Bergamini1, S. Alfieri1, C. Resteghini1, D. Galbiati1, E. Orlandi2, N.A. Iacovelli2, G. Calareso3, M. Guzzo4, P. Quattrone5, L. Licitra6, P. Bossi1
  • 1Head And Neck Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 2Radiotherapy, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 3Radiology, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 4Otorhinolaryngology, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 5Pathology, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 6Head And Neck Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori - Università degli studi di Milano, 20133 - Milan/IT

Abstract

Background

Multimodality treatment (MMT) is the current approach to advanced sinonasal cancers (SC). We lack salvage treatment standardization especially for pts already receiving MMT. No clinical factors able to predict outcome have been identified in this disease setting.

Methods

We retrospectively analyzed a series of pts with recurrent/metastatic (RM) SC after multimodal curative treatment, consisting in induction chemotherapy (iCT) followed by locoregional therapy. Overall survival (OS) was measured as the interval from relapse to death.

Results

Among 106 pts with SC treated with MMT at our Center from 1997 to 2016, 50 (M/F 31/19) relapsed. Median age was 53 yrs (16-73). Median follow-up was 26 months (m) (5-192). WHO 2005 histotypes were: 36% sinonasal undifferentiated carcinoma (SNUC), 34% squamous cell cancer (SCC), 30% carcinomas with neuroendocrine differentiation (CND). Median time to first relapse after curative treatment was 13.5 m. Median OS was 13 m from recurrence: 19 m in SCC, 16 m in SNUC and 6 m in CND (p = .34). Relapse occurred as distant metastasis in 40%, as nodal recurrence in 6% and at primary site in 54% of cases. First line salvage treatment was surgery in 38% (14 pts received surgery on T, 2 on N and 3 on M), CT in 30%, RT in 8%, best supportive care in the remaining pts. Median OS was 31 m in surgically treated pts and 4.8 m in those receiving CT (p < .0001). In pts with disease control (PR+SD) after iCT, median OS after recurrence was longer than in pts with PD (13.4 vs 1.5 m, p = .07). Median OS from relapse was 29.6 m in pts with CR after definitive treatment, 7.1 m in those with PR and 3.4 m in those with PD (p = .002). Pts with an objective response to palliative CT had a longer median OS than those with PD (20 vs 4 m, p = .002).

Conclusions

Prognosis of SC relapsing after MMT is dismal. With the caveat of a retrospective analysis and a case series that has been collected in a long time frame, we showed that feasibility of salvage surgery, objective response to prior definitive treatment and response to palliative CT are factors associated with better outcomes. Pts with relapsed or metastatic SC not amenable to salvage surgery should be considered for enrolment in clinical trials.

Clinical trial identification

Legal entity responsible for the study

Fondazione IRCCS Istituto Nazionale Tumori Milano - Università degli Studi di Milano. Italy

Funding

None

Disclosure

All authors have declared no conflicts of interest.