To determine if endoscopic resection of selected Sinonasal Undifferentiated Carcinomas (SNUC) is acceptable in terms of outcome when compared with traditional craniofacial resection.
A large single institution cohort study with prospectively collected data and extended follow-up (up to 120 months).
The cohort consists of 13 craniofacial resections (CFR), 6 endoscopic resections (ESS). The majority of patients in both CFR and ESS groups had tumour staging of T4. Overall sex distribution was 15:4 (male:female), mean age of onset was 50.9 years (range 21-79) and follow up was between 6-120 months. In the CFR group, 8 had adjuvant chemoradiation, 4 had radiation alone and 1 died in the immediate post-operative period before chemoradiation; In the CFR group, 1 is alive and well (follow-up 12 months), 8 died of their disease (mean survival 18m, range 6-46m), 4 were lost to follow up. Those patients who had ESS all received adjuvant chemoradiation, 5 are alive and well (range 12-120m), and 1 died of disease (36 months). In the comparative CFR group, 1 patient is alive and well (follow-up 12 months), 4 died of their disease (mean survival 14 months, range 10-22), 3 were lost to follow up.
In selected less extensive cases, SNUC can be managed endoscopically with comparable results to conventional CFR. However, in general the prognosis in these patients is poor and irrespective of the form of surgery there is clear evidence in the literature that all patients should be treated additionally with chemoradiation.