Epidemiology and Management of Sinonasal Adenocarcinoma in Ireland – Experience of The National Centre for Skull Base Cancer
Dr Alison McHugh, Senior Registrar, Beaumont Hospital, Dublin, Ireland
Authors List
McHugh, A., O’Byrne, O’Neill, J.P., Lacy, P., Woods, R.,
Department of Otolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin Ireland
L., Barrett, H., Department of Histopathology, Beaumont Hospital, Dublin, Ireland
Background: Sinonasal adenocarcinoma is a rare malignancy of the nasal cavity and paranasal sinuses which requires aggressive multi-disciplinary management to achieve optimum outcomes. Due to its rarity and often innocuous symptoms, it may present late, adding to the complexity of management. Sinonasal adenocarcinomas are divided into salivary-type and intestinal-type and non-intestinal-type adenocarcinomas. The mainstay of management is negative surgical margins, a goal made more challenging by complex anatomy and neighbouring vital structures. Survival disparities have been previously described between rural and urban populations.
Methods: A retrospective cohort study of data from the National Cancer Registry of Ireland was performed between 1994 and 2022. Epidemiology and disease survival were analysed. A retrospective chart review was performed of patients presenting with complex sinonasal adenocarcinoma to a tertiary referral skull base centre in Ireland. Patient demographics, presenting features, treatment plans, surgical approaches, complications and outcomes were recorded. Histopathological features including margin status and p53 expression were reviewed. Descriptive and inferential statistics were used to analyse trends and outcomes.
Results: Adenocarcinoma accounted for 15.4% of primary sinonasal malignancies seen nationally. 58 cases of sinonasal adenocarcinoma were identified over a 25 year period in the Republic of Ireland. Demographic features and survival are described. An increasing proportion of these cases were managed at the National Centre for Skull Base Cancer. Modalities of treatment included surgery in most cases, and radiation in some cases.
Conclusions: An aggressive primary surgical approach remains the standard of care in the management of sinonasal adenocarcinoma. Evolving multi-disciplinary strategies, in particular secondary to biological profiling, allow for management approaches with enhanced patient outcomes. Despite numeric limitations of this study, it confirms the trends of incidence previously described in the literature. We present our national demographics and local experience of this challenging disease and the lessons learned by our skull base team.
McHugh, A., O’Byrne, O’Neill, J.P., Lacy, P., Woods, R.,
Department of Otolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin Ireland
L., Barrett, H., Department of Histopathology, Beaumont Hospital, Dublin, Ireland
Background: Sinonasal adenocarcinoma is a rare malignancy of the nasal cavity and paranasal sinuses which requires aggressive multi-disciplinary management to achieve optimum outcomes. Due to its rarity and often innocuous symptoms, it may present late, adding to the complexity of management. Sinonasal adenocarcinomas are divided into salivary-type and intestinal-type and non-intestinal-type adenocarcinomas. The mainstay of management is negative surgical margins, a goal made more challenging by complex anatomy and neighbouring vital structures. Survival disparities have been previously described between rural and urban populations.
Methods: A retrospective cohort study of data from the National Cancer Registry of Ireland was performed between 1994 and 2022. Epidemiology and disease survival were analysed. A retrospective chart review was performed of patients presenting with complex sinonasal adenocarcinoma to a tertiary referral skull base centre in Ireland. Patient demographics, presenting features, treatment plans, surgical approaches, complications and outcomes were recorded. Histopathological features including margin status and p53 expression were reviewed. Descriptive and inferential statistics were used to analyse trends and outcomes.
Results: Adenocarcinoma accounted for 15.4% of primary sinonasal malignancies seen nationally. 58 cases of sinonasal adenocarcinoma were identified over a 25 year period in the Republic of Ireland. Demographic features and survival are described. An increasing proportion of these cases were managed at the National Centre for Skull Base Cancer. Modalities of treatment included surgery in most cases, and radiation in some cases.
Conclusions: An aggressive primary surgical approach remains the standard of care in the management of sinonasal adenocarcinoma. Evolving multi-disciplinary strategies, in particular secondary to biological profiling, allow for management approaches with enhanced patient outcomes. Despite numeric limitations of this study, it confirms the trends of incidence previously described in the literature. We present our national demographics and local experience of this challenging disease and the lessons learned by our skull base team.
