Survival rates of sinonasal squamous cell carcinoma with the new AJCC staging system

Abstract

OBJECTIVE: To investigate the validity of the sixth edition of the American Joint Committee on Cancer (AJCC) staging system for sinonasal squamous cell carcinoma. DESIGN: A 15-year retrospective case series review. SETTING: Multicenter study from tertiary care facilities. PATIENTS: Data from 113 patients diagnosed as having and treated for sinonasal squamous cell carcinoma from September 1988 through August 2003 were retrieved. Ninety patients followed up for at least 12 months were included in the study. MAIN OUTCOME MEASURES: The TNM staging system and survival rates were analyzed using the Kaplan-Meier method to determine the mean, disease-free, and 5-year survival statistics. The effect of tumor stage on overall survival was assessed with stages defined by the fifth and sixth editions of the AJCC staging systems. RESULTS: The overall 5-year survival rate was 59.5%. According to the sixth edition, the survival rates of patients with stages III, IVA, and IVB tumors showed a significant difference (P = .002). In 32 cases, the stages were changed in accordance with the criteria in the sixth edition. The group in which the stage changed from III (fifth edition) to IVA (sixth edition) showed a worse survival rate than the group in which the stage did not change, although the difference was statistically insignificant. The 5-year disease-free survival rates of the group in which the stage did not change and of the group in which the stage changed from III (fifth edition) to IVA (sixth edition) were 64% and 34%, respectively (P = .08). Local recurrence was more frequently observed in the group in which the stage changed from III (fifth edition) to IVA (sixth edition). CONCLUSION: The new AJCC staging system seems to be more accurate in predicting the survival rates for patients with advanced but surgically resectable sinonasal squamous cell carcinoma (stage IVA).