Outcomes of SMARCB1-deficient sinonasal carcinoma: Largest single-center cross-sectional study

Head Neck. 2024 Dec;46(12):3076-3084. doi: 10.1002/hed.27859. Epub 2024 Jul 23.

Abstract

Background: We evaluate outcomes of SMARCB1-deficient sinonasal carcinomas in the largest single-institution study.

Methods: Retrospective cross-sectional study of patients with SMARCB1-deficient sinonasal carcinoma between 1998 and 2024. Disease-specific survival (DSS) and recurrence-free probability (RFP) at 1 and 5 years were measured by Kaplan-Meier method.

Results: There were 47 patients with a median age of 53. Initial pathological diagnosis was altered in 33%. Twelve (34%) patients received neoadjuvant chemotherapy, with one partial response. Curative surgical approach was undertaken in 73%. Definitive chemoradiation was administered in 20%. DSS at 1 and 5 years was 93% and 45%, respectively. RFP at 1 and 5 years was 73% and 33%, respectively. On multivariate analysis, cranial nerve involvement (p = 0.01 for DSS) remained significantly worse for DSS and overall survival.

Conclusions: SMARCB1-deficient tumors had limited response to neoadjuvant chemotherapy. Cranial nerve involvement was associated with worse prognosis. Optimal treatment is unclear. Surgery should be offered to patients with resectable disease.

Keywords: INI‐1; SMARCB‐1; induction chemotherapy; sinonasal carcinoma; skull base.

MeSH terms

  • Adult
  • Aged
  • Carcinoma / genetics
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Carcinoma / therapy
  • Cross-Sectional Studies
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Paranasal Sinus Neoplasms* / genetics
  • Paranasal Sinus Neoplasms* / mortality
  • Paranasal Sinus Neoplasms* / pathology
  • Paranasal Sinus Neoplasms* / therapy
  • Prognosis
  • Retrospective Studies
  • SMARCB1 Protein* / deficiency
  • SMARCB1 Protein* / genetics
  • Treatment Outcome

Substances

  • SMARCB1 Protein
  • SMARCB1 protein, human