Background Sinonasal undifferentiated carcinoma (SNUC) is a rare, highly aggressive malignancy that can involve the skull base, nasal cavities, and paranasal sinuses. As a result, there is a paucity of research and evidence to inform optimal management and guide prognostication. This consumer-initiated project aims to describe the epidemiology of SNUC in Queensland including: diagnosis, recurrence, and impact of cancer therapy on survival.
Methods Data on all Queensland patients diagnosed with SNUC between 1982 and 2021 were sourced from the Queensland Oncology Repository. A comprehensive review was undertaken for each case and information was collected in a SNUC Clinical Quality Registry (CQR).
Results From 1982 to 2021, there were 58 Queenslanders diagnosed with SNUC (57% male, median age 58 years). The incidence of 0.01 per 100,000 identifies it as a very rare cancer. At baseline, most had advanced disease (43% stage IV, 19% stage III) and 40% had ≥2 co-morbidities. Treatments included: trimodality with surgery, radiation and chemotherapy (26%); chemoradiation (22%); surgery with either chemotherapy or radiation (16%); single modality (19%); or no treatment (17%). Recurrence occurred in 43% after a median time of 353 days. All-cause 5-year survival was 56% for trimodality; 44% for surgery plus either chemotherapy/radiation; 38% for chemoradiation; 18% for single modality and 20% for no treatment. Overall 5-year survival was 37%, but this has improved over the last 2 decades from 27% (1992-2001) to 42% (2012-2021).
Conclusions While survival following a diagnosis of SNUC remains poor, multimodality treatment appears to have a survival advantage. Further analysis will examine prognostic and molecular biomarkers to improve outcomes.