Predictors of distant metastases in sinonasal and skull base cancer patients treated with surgery Journal Article
| Authors: | Valero, C.; Adilbay, D.; Fitzgerald, C. W. R.; Yuan, A.; Mimica, X.; Gupta, P.; Wong, R. J.; Shah, J. P.; Patel, S. G.; Cohen, M. A.; Ganly, I. |
| Article Title: | Predictors of distant metastases in sinonasal and skull base cancer patients treated with surgery |
| Abstract: | Objectives: Sinonasal and skull base tumors comprise a heterogeneous group of malignancies with a significant rate of distant recurrence (DR). The aim of this study was to analyze tumor and host factors, including pretreatment neutrophil-to-lymphocyte ratio (NLR), that predict DR in these patients. Materials and Methods: We retrospectively reviewed sinonasal tumors and/or tumors involving the skull base treated with surgery between 1973 and 2015 (n = 473). We stratified NLR using the top 5 percentile as cutoff. Factors predictive of outcome were determined by Cox proportional hazards model. Results: Most tumors were primary (81%) and 67% had skull base resection. The most common site was the nasal cavity (37%) and the most common histology was squamous cell carcinoma (34%). Most patients presented with advanced primary tumor stage (pT3/T4; 80%) and most had no regional neck disease (pNx/N0; 93%). A total of 104 patients developed DR. The 5-year overall and disease-specific survival for patients who developed DR were 36.4% and 35.8%, compared to 69.0% and 74.9% for patients who did not. Patients with DR had a higher percentage of NLR-high patients compared patients without DR (11% vs 3%, p =.006). In a multivariable analysis, melanoma histology (HR = 5.469, 95% CI 3.171–9.433), pT3/T4 (HR = 2.686, 95% CI 1.150–6.275), pN+ (HR = 6.864, 95% CI 3.450–13.653), and NLR-high (HR = 3.489, 95% CI 1.593–7.639) were independent predictors of DR. Conclusion: Melanoma histology, pT, pN, and high NLR predict DR, suggesting that both tumor and host factors need to be considered. NLR may act as a surrogate marker of the host́s immune system. © 2021 Elsevier Ltd |
| Keywords: | melanoma; distant metastasis; sinonasal cancer; host factors; neutrophil-to-lymphocyte ratio; skull base cancer |
| Journal Title: | Oral Oncology |
| Volume: | 122 |
| ISSN: | 1368-8375 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2021-11-01 |
| Start Page: | 105575 |
| Language: | English |
| DOI: | 10.1016/j.oraloncology.2021.105575 |
| PROVIDER: | scopus |
| PMCID: | PMC8596462 |
| PUBMED: | 34689008 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 December 2021 -- Source: Scopus |
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