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Survival and Factors Influencing Prognosis

Neil Bhattacharyya, MD

Arch Otolaryngol Head Neck Surg. 2002;128:1079-1083.

Objective  To determine overall survival and prognostic factors for cancer of the nasal cavity.

Design  Cross-sectional analysis of a national cancer database.

Methods  All cases of nasal cavity cancer were extracted from the Surveillance, Epidemiology and End Results database for 1988 through 1998. Cases with distant metastatic disease were excluded. Tumor histologic types, TNM staging, and pathological features were computed. Kaplan-Meier and Cox proportional hazards analyses were conducted to determine factors influencing overall survival.

Results  A total of 981 cases were identified, with 3.5% presenting with distant metastatic disease. After exclusion of missing variables, 783 cases were analyzed, with a mean patient age of 63.8 years. Squamous cell carcinoma was the most common tumor histologic type (49.3%), followed by esthesioneuroblastoma (13.2%). More than half of the cases presented with early (T1) primary site disease, and only 5% had positive nodal disease at presentation. Overall mean (median) survival was 76 (81) months, with an overall 5-year survival rate of 56.7%. On multivariate analysis, male sex, increasing age, T stage, N stage, and poorer tumor grade independently adversely affected survival (P<.05). Radiotherapy was administered in 50.5% of patients and also independently predicted poorer survival (P = .03). The mean (median) survival for squamous cell carcinoma was 79 (84) months; only melanoma showed a statistically significantly poorer mean survival of 40 (30) months when compared with other tumors (P<.001).

Conclusions  Age, sex, and staging variables have a significant prognostic impact in nasal cavity cancer. Melanomas of the nasal cavity manifest very poor survival.

From the Division of Otolaryngology, Brigham and Women's Hospital, Department of Otology and Laryngology, Harvard Medical School, Boston, Mass.

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