Abstract
Purpose of Review
To provide a comprehensive review of the literature highlighting the recent advances in the diagnosis and management of sinonasal undifferentiated carcinoma (SNUC)
Recent Findings
SNUC usually presents at advanced stage and the prognosis is usually poor with high rates of locoregional recurrence and tendency to metastasize. Special attention should be made in differentiating SNUC from other sinonasal malignancies in order to guide the appropriate treatment accordingly. Multimodality treatment is usually recommended for treating SNUC. The use of neoadjuvant chemotherapy may be associated with improved outcome and can be used to guide the subsequent treatment selection.
Summary
Despite the recent advances in chemotherapeutic agents, radiation techniques, and surgical approaches, the prognosis and survival outcomes of SNUC remain poor. The addition of induction chemotherapy to the treatment approach followed by definitive local therapy needs to be further studied as it might improve the outcome.
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References
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Frierson HF Jr, Mills SE, Fechner RE, Taxy JB, Levine PA. Sinonasal undifferentiated carcinoma: an aggressive neoplasm derived from Schneiderian epithelium and distinct from olfactory neuroblastoma. Am J Surg Pathol. 1986;10(11):771–2.
Ejaz A, Wenig BM. Sinonasal undifferentiated carcinoma: clinical and pathologic features and a discussion on classification, cellular differentiation, and differential diagnosis. Adv Anat Pathol. 2005;12(3):134–43.
Mendenhall WM, Mendenhall CM, Riggs CE Jr, Villaret DB, Mendenhall NP. Sinonasal undifferentiated carcinoma. Am J Clin Oncol. 2006;29(1):27–31.
Rischin D, Porceddu S, Peters L, Martin J, Corry J, Weih L. Promising results with chemoradiation in patients with sinonasal undifferentiated carcinoma. Head Neck. 2004;26(5):435–41.
Reiersen DA, Pahilan ME, Devaiah AK. Meta-analysis of treatment outcomes for sinonasal undifferentiated carcinoma. Otolaryngol Head Neck Surg. 2012. https://doi.org/10.1177/0194599812440932.
Gray ST, Herr MW, Sethi RK, Diercks G, Lee L, Curry W, et al. Treatment outcomes and prognostic factors, including human papillomavirus, for sinonasal undifferentiated carcinoma: a retrospective review. Head Neck. 2015;37(3):366–74.
Musy PY, Reibel JF, Levine PA. Sinonasal undifferentiated carcinoma: the search for a better outcome. Laryngoscope. 2002;112(8):1450–5.
Tanzler ED, Morris CG, Orlando CA, Werning JW, Mendenhall WM. Management of sinonasal undifferentiated carcinoma. Head Neck. 2008;30(5):595–9.
Enepekides DJ. Sinonasal undifferentiated carcinoma: an update. Curr Opin Otolaryngol Head Neck Surg. 2005;13(4):222–5.
Thompson LDR, Bell D, Bishop JA. Neuroendocrine carcinomas. In: El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg P, editors. Pathology and genetics of head and neck tumours. Lyon: IARC Press; 2017. p. 21–3.
Bell D, Franchi A, Gillison M, Thompson LDR, Wenig BM. Olfactory neuroblastoma. In: El Naggar AK, JKC C, Grandis JR, Takata T, Slootweg P, editors. Pathology and genetics of head and neck tumours. Lyon: IARC Press; 2017. p. 57–9.
Bell D, Hanna EY. Sinonasal undifferentiated carcinoma: morphological heterogeneity, diagnosis, management and biological markers. Expert Rev Anticancer Ther. 2013;13(3):285–96.
López-Hernández A, Vivanco B, Franchi A, Bloemena E, Cabal VN, Potes S, et al. Genetic profiling of poorly differentiated sinonasal tumours. Sci Rep. 2018;8(1):3998.
Cerilli LA, Holst VA, Brandwein MS, Stoler MH, Mills SE. Sinonasal undifferentiated carcinoma: immunohistochemical profile and lack of EBV association. Am J Surg Pathol. 2001;25(2):156–63.
Bell D, Hanna EY, Weber RS, De Monte F, Triantafyllou A, Lewis JS, et al. Neuroendocrine neoplasms of the sinonasal region. Head & Neck. 2015.
Wenig BM. Undifferentiated malignant neoplasms of the sinonasal tract. Arch Pathol Lab Med. 2009;133(5):699–712.
Soldatova L, Campbell RG, Carrau RL, Prevedello DM, Wakely P, Otto BA, et al. Sinonasal carcinomas with neuroendocrine features: histopathological differentiation and treatment outcomes. J Neurol Surg B Skull Base. 2016. https://doi.org/10.1055/s-0036-1582432.
Franchi A, Miligi L, Palomba A, Giovannetti L, Santucci M. Sinonasal carcinomas: recent advances in molecular and phenotypic characterization and their clinical implications. Crit Rev Oncol Hematol. 2011;79(3):265–77.
Franchi A, Moroni M, Massi D, Paglierani M, Santucci M. Sinonasal undifferentiated carcinoma, nasopharyngeal-type undifferentiated carcinoma, and keratinizing and nonkeratinizing squamous cell carcinoma express different cytokeratin patterns. Am J Surg Pathol. 2002;26(12):1597–604.
Wadsworth B, Bumpous JM, Martin AW, Nowacki MR, Jenson AB, Farghaly H. Expression of p16 in sinonasal undifferentiated carcinoma (SNUC) without associated human papillomavirus (HPV). Head Neck Pathol. 2011;5(4):349–54.
Gil Z, Orr-Urtreger A, Voskoboinik N, Trejo-Leider L, Spektor S, Shomrat R, et al. Cytogenetic analysis of sinonasal carcinomas. Otolaryngol Head Neck Surg. 2006;134(4):654–60.
Takahashi Y, Kupferman ME, Bell D, Jiffar T, Lee JG, Xie T-X, et al. Establishment and characterization of novel cell lines from sinonasal undifferentiated carcinoma. Clin Cancer Res. 2012;18(22):6178–87.
Bishop JAAC, Westra WH. SMARCB1 (INI-1)-deficient carcinomas of the sinonasal tract. Am J Surg Pathol. 2014;38:1282–9.
Agaimy A, Koch M, Lell M, Semrau S, Dudek W, Wachter DL, et al. SMARCB1(INI1)-deficient sinonasal basaloid carcinoma: a novel member of the expanding family of SMARCB1-deficient neoplasms. Am J Surg Pathol. 2014;38:1274–81.
Bell DHE, Agaimy A, Weissferdt A. Reappraisal of sinonasal undifferentiated carcinoma: SMARCB1 (INI1)-deficient sinonasal carcinoma: a single-institution experience. Virchows Arch. 2015;467(6):649–56.
Lewis J, Bishop JA, Gillisson M, Westra WH, Yarborough WG. Sinonasal undifferentiated carcinoma. In: El-Naggar AK, JKC C, Grandis JR, Takata T, Slootweg P, editors. Pathology and genetics of head and neck tumours. Lyon: IARC Press; 2017. p. 18–20.
Dogan S, Frosina D, Fayad M, de Oliveira TB, Alemar B, Rosenblum M, et al. The role of a monoclonal antibody 11C8B1 as a diagnostic marker of IDH2-mutated sinonasal undifferentiated carcinoma. Mod Pathol 2018;1. https://doi.org/10.1038/s41379-018-0126-3.
Rosenthal DI, Barker JL, El-Naggar AK, Glisson BS, Kies MS, Diaz EM, et al. Sinonasal malignancies with neuroendocrine differentiation. Cancer. 2004;101(11):2567–73.
Chen AM, Daly ME, El-Sayed I, Garcia J, Lee NY, Bucci MK, et al. Patterns of failure after combined-modality approaches incorporating radiotherapy for sinonasal undifferentiated carcinoma of the head and neck. Int J Radiat Oncol Biol Phys. 2008;70(2):338–43.
Lin EM, Sparano A, Spalding A, Eisbruch A, Worden FP, Heth J, et al. Sinonasal undifferentiated carcinoma: a 13-year experience at a single institution. Skull Base. 2010;20(02):061–7.
Al-Mamgani A, van Rooij P, Mehilal R, Tans L, Levendag PC. Combined-modality treatment improved outcome in sinonasal undifferentiated carcinoma: single-institutional experience of 21 patients and review of the literature. Eur Arch Otorhinolaryngol. 2013;270(1):293–9.
Mourad WF, Hauerstock D, Shourbaji RA, Hu KS, Culliney B, Li Z, et al. Trimodality management of sinonasal undifferentiated carcinoma and review of the literature. Am J Clin Oncol. 2013;36(6):584–8.
van der Laan TP, Bij HP, van Hemel BM, Plaat BE, Wedman J, van der Laan BF, et al. The importance of multimodality therapy in the treatment of sinonasal neuroendocrine carcinoma. Eur Arch Otorhinolaryngol. 2013;270(9):2565–8.
• Chambers KJ, Lehmann AE, Remenschneider A, Dedmon M, Meier J, Gray ST, et al. Incidence and survival patterns of sinonasal undifferentiated carcinoma in the United States. J Neurol Surg B Skull Base. 2015;76(02):094–100 Large National Cancer Institute’s Surveillance Epidemiology and End Results data that included 318 SNUCs. They found a survival benefit of surgery and radiation therapy with a trend toward improved survival in recent years.
• de Bonnecaze G, Verillaud B, Chaltiel L, Fierens S, Chapelier M, Rumeau C, et al. Clinical characteristics and prognostic factors of sinonasal undifferentiated carcinoma: a multicenter study. Int Forum Allergy Rhinol. 2018;8(9):1065–72 A larger multicenter collabrative study evaluating the treatment outcomes and prognostic factors of SNUC. Overall, multimodal therapies including induction chemotherapy and intensity-modulated radiotherapy may improve the prognosis of SNUC.
Kuan EC, Arshi A, Mallen-St Clair J, Tajudeen BA, Abemayor E, St John MA. Significance of tumor stage in sinonasal undifferentiated carcinoma survival a population-based analysis. Otolaryngol Head Neck Surg. 2016. https://doi.org/10.1177/0194599816629649.
Fried D, Zanation AM, Huang B, Hayes N, Morris DE, Rosenman J, et al. Management of nonesthesioneuroblastoma sinonasal malignancies with neuroendocrine differentiation. Laryngoscope. 2012;122(10):2210–5.
Kim BS, Vongtama R, Juillard G. Sinonasal undifferentiated carcinoma: case series and literature review. Am J Otolaryngol. 2004;25(3):162–6.
Rischin D, Coleman A. Sinonasal malignancies of neuroendocrine origin. Hematol Oncol Clin North Am. 2008;22(6):1297–316.
• Amit M, Abdelmeguid AS, Watcherporn T, Tam S, Bell D, Ferrarotto R, Glisson B, et al. Induction chemotherapy response as a guide for treatment optimization in sinonasal undifferentiated carcinoma. J Clin Oncol. 2019;37(6):504–12. The largest retrospective study in the literature from a single institution describing the use of induction chemotherapy to guide the subsequent treatment selection in SNUC based on the response.
Takahashi Y, Lee J, Pickering C, Bell D, Jiffar TW, Myers JN, et al. Human epidermal growth factor receptor 2/neu as a novel therapeutic target in sinonasal undifferentiated carcinoma. Head Neck. 2016;38:E1926–34.
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Abdelmeguid, A.S., Bell, D. & Hanna, E.Y. Sinonasal Undifferentiated Carcinoma. Curr Oncol Rep 21, 26 (2019). https://doi.org/10.1007/s11912-019-0776-4
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DOI: https://doi.org/10.1007/s11912-019-0776-4