1028P - Sinonasal adenocarcinoma (SNA) - Experience of an oncology center

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Head and Neck Cancers
Presenter Diogo Costa
Citation Annals of Oncology (2014) 25 (suppl_4): iv340-iv356. 10.1093/annonc/mdu340
Authors D.A. Costa1, E.J. Gouveia1, T. Andre1, S. Esteves2, I. Sargento1, J. Freire1, M. Ferreira1, A. Moreira1
  • 1Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E. (IPOLFG EPE), 1099-023 - Lisboa/PT
  • 2Clinical Trials, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E. (IPOLFG EPE), 1099-023 - Lisboa/PT



Sinonasal cancer represent 3% of all head and neck cancers, with an annual European incidence of 1-2/100000. Squamous cell carcinoma is the most frequent type, and adenocarcinoma accounts for 10-20%. The average age is 50-60 years (yrs), with male predominance. Occupational wood exposure is considered a risk factor. SNA grows silently which leads to a late diagnosis and low survival rates.


32-year (1981-2013) retrospective cohort analysis of all consecutive patients (pts) with histologically confirmed primary SNA, diagnosed/treated in our tertiary cancer centre. Medical records were reviewed. Survival analysis was done using Kaplan-Meier estimator and log-rank/Peto tests.


From 275 pts with sinonasal cancer, 31 were SNA. Patient median age was 70 yrs (49-108), 54.8% male. 38.7% had professional exposure to leather dust/wood/cork. Primary sites at diagnosis were: nasal cavity (48.4%), maxillary sinus (3.3%), ethmoid sinus (3.3%). Nasal obstruction (74.3%), epistaxis (45.2%) were the most common presenting symptoms. Most pts (54.8%) presented with stage III and stage IV disease at diagnosis and 45.2% with stage I/II. The Intestinal-Type SNA (ITAC) was the most common type of adenocarcinoma (61.3%) followed by tubulopapillary (22.6%). The median time between the first symptom and the definitive diagnosis was 5 months (0-39) and from the diagnosis to the initial treatment was 2 months (0-9). Surgery was the primary treatment in 77.4%. Adjuvant radiation was performed in 51.6% and chemotherapy in 3.3%. Recurrence was seen in 13 pts (41.9%): 28.7% recurred locally, 6.6% systemically, and 6.6% both. The median follow-up, overall survival (OS) and progression free-survival (PFS) were 3.5 yrs, 5.45 yrs and 3.41 yrs, respectively. Mucinous ITAC subtype had a dismal outcome (7/8 pts died), with a median OS and PFS of 4.76 yrs and 2.8 yrs, respectively.

Stage I/II Stage III/IV p value
OS 10.02 yrs 3.51 yrs 0.0179, log-rank
PFS 4.14 yrs 2.27 yrs 0.0573, peto-test


Our results suggest a tendency of SNA to late diagnosis and an occupational exposure as predisposing factor. In our series ITAC was the most frequent histological type and mucinous subtype tends to worse the outcome.


All authors have declared no conflicts of interest.