Survival Rates for Sinonasal Adenocarcinoma
Sinonasal cancers represent only 3% of head and neck tumors, among the rarest cancer types found in medicine. The American Cancer Society says roughly 2,000 people develop these cancer types every year. Sinonasal adenocarcinoma is the most common sinonasal cancer, representing 10 to 20% of sinonasal malignancies.
Alyson Littman and Thomas L. Vaughn wrote in Cancer Epidemiology and Prevention in 2006 that a defining sinonasal cancer characteristic is its strong association with occupational chemical exposure, particularly dusts.
“The identification of clusters of sinonasal adenocarcinomas occurring among workers in the furniture, leather, and shoe manufacturing industries, as well as in nickel refining has led to the designation of sinonasal cancer as a ‘sentinel health event,’ indicating a possibly harmful occupational environment when diagnosed in an employee of an at-risk industry,” Littman and Vaughn wrote.
A study published on Jan. 5, 2015 in the Journal of Neurological Surgery, “Predictors of Survival in Sinonasal Adenocarcinoma (Chen),” outlines several sinonasal adenocarcinoma survival predictors.
The Chen study identified 325 sinonasal adenocarcinoma patients. Doctors found 300 patients had the more common non-intestinal adenocarcinoma, and 25 patients had the intestinal type, known as ITAC. ITAC can sometimes mimic the appearance of intestinal cancer or the normal appearance of the intestinal lining, hence the designation.
The Chen researchers further categorized patients by age, gender and race, and examined cancer site, stage, grade, disease extent, diagnosis year and treatment received. The study found black patients, patients aged 75 or older, patients with high grade cancers, and patients with paranasal sinus tumors face the worst survival probabilities.
Survival rate analysis by race demonstrated five-year disease specific survival rates of 75.1%, 73.1%, and 44.6% for white, other, and black patients, respectively. In layman’s terms, roughly three-quarters of whites and patients of other races were still alive five years after their diagnosis, while less than half of black patients were still alive in the same time period.
The Chen study said previous research shows sinonasal cancer incidence dropping in the black population, but with a corresponding survival decrease. Researchers attribute that drop partly to socioeconomic status differences and health care access. In essence, a person’s wealth, income and health care availability can greatly impact their survival rate.
The study also connected advanced age and poor survival outcomes. The Chen researchers found a statistically significantly worse survival rate for patients aged 75 or older. The researchers said although there is very little data on the association between age and sinonasal adenocarcinoma survival, older male patients tended to have higher grade, deadlier tumors.
The researchers found no difference in survival rates between nonintestinal- and intestinal-type sinonasal adenocarcinoma. Additionally, they did not find any meaningful variance in survival rates sorted by diagnosis year. However, the study found a marked difference in survival rates depending on the treatment received.
The Chen study determined patients undergoing surgery showed better survival rates than patients undergoing radiation therapy alone. However, the study found no appreciable outcome difference between patients undergoing surgery and patients receiving both surgery and post-surgery radiation therapy.
The Chen researchers acknowledged limitations in their study, specifically a potential selection bias in improved survival rates associated with surgery. The relatively low sinonasal adenocarcinoma incidence presented another challenge. The scientists used data from the Surveillance Epidemiology and End Results (SEER) database to overcome the sample size limitation, though they said using such a large database creates the possibility of misclassification and coding errors.
The trial attorneys of Allen Stewart, P.C. have decades of combined experience in helping those who have developed cancer due to toxic exposure. If you believe your recent sinonasal adenocarcinoma diagnosis is related to an occupational exposure, don’t hesitate to reach out and talk with our team.