{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T02:36:45Z","timestamp":1779158205065,"version":"3.51.4"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aims of this study were to analyze the clinical characteristics of patients with recurrent and metastatic sinonasal undifferentiated carcinoma (SNUC) and evaluate the current treatment strategies to help guide future management.<\/jats:p><jats:p>This is a retrospective cohort study.<\/jats:p><jats:p>The study was conducted at six international tertiary treatment centers.<\/jats:p><jats:p>Patients with documented diagnoses of recurrent or metastatic SNUC since 1983 were included in the study.<\/jats:p><jats:p>Patient demographics and clinical characteristics were collected. Primary outcome measures included disease-specific survival (DSS), overall survival (OS), and time to recurrence (TTR) following initial treatment. Further univariable and multivariable analyses were performed to assess for prognostic factors.<\/jats:p><jats:p>A total of 97 patients with a mean (standard deviation [SD]) age of 52.4 (15.6) were identified, 15 of whom presented with metastatic SNUC and 90 of whom developed recurrence. Management in both populations was widely variable. For patients with metastatic disease, the 1-year DSS probability was 33.3% (95% confidence interval [CI], 10.8\u2013100%). For patients with recurrent SNUC, the 1- and 5-year DSS probabilities were 45.7% (95% CI, 31.9\u201365.6%) and 8.6% (95% CI, 2.9\u201325.3%), respectively. The median (interquartile range [IQR]) TTR was 8 months (3\u201318.5 months). Multivariable analyses revealed a significant association between orbital involvement on initial presentation and TTR (hazard ratio [HR]\u2009=\u20093.28; 95% CI, 1.45\u20137.42; p\u2009=\u20090.004).<\/jats:p><jats:p>To our knowledge, this is the first study addressing metastatic and recurrent SNUC based on a large patient cohort. Orbital extension of the primary SNUC may predict a higher probability of recurrence following treatment, suggesting the possible utility of a more aggressive treatment in this subgroup of patients. A heterogenous patient population and wide variability in management emphasize the challenges in standardizing care; however, dismal survival rates demonstrate the necessity for further evaluation of current approaches to improve evidence-based recommendations.<\/jats:p>","DOI":"10.1055\/s-0044-1791573","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T18:55:05Z","timestamp":1727981705000},"page":"538-546","source":"Crossref","is-referenced-by-count":2,"title":["International, Multi-Institutional Evaluation of Practice Patterns and Outcomes for Recurrent and Metastatic Sinonasal Undifferentiated Carcinoma"],"prefix":"10.1055","volume":"86","author":[{"given":"Anirudh","family":"Saraswathula","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States"},{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3263-983X","authenticated-orcid":false,"given":"Mohammed N.","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States"},{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacklyn","family":"Liu","sequence":"additional","affiliation":[{"name":"UCL Cancer Institute, University College London and Head and Neck Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoko","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arushi","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simonetta","family":"Battocchio","sequence":"additional","affiliation":[{"name":"Department of Molecular and Translational Medicine, University of Brescia, ASST Spedali Civili, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Bossi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"},{"name":"Head and Neck Cancer Medical Oncology Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Castelnuovo","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Facco","sequence":"additional","affiliation":[{"name":"Unit of Pathology, ASST Sette Laghi, University of Insubria, Varese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4023-0121","authenticated-orcid":false,"given":"Marco","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Section of Otorhinolaryngology \u2013 Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn","family":"Carnell","sequence":"additional","affiliation":[{"name":"UCL Cancer Institute, University College London and Head and Neck Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin D.","family":"Forster","sequence":"additional","affiliation":[{"name":"UCL Cancer Institute, University College London and Head and Neck Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Franchi","sequence":"additional","affiliation":[{"name":"Department of Translational Research, University of Pisa, Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amrita","family":"Jay","sequence":"additional","affiliation":[{"name":"Department of Histopathology, University College London Hospitals NHS Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology \u2013 Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie J.","family":"Lund","sequence":"additional","affiliation":[{"name":"Royal National Ear, Nose, Throat and Eastman Dental Hospital, University College London Hospitals NHS Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Mattavelli","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology \u2013 Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piero","family":"Nicolai","sequence":"additional","affiliation":[{"name":"Section of Otorhinolaryngology \u2013 Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vittorio","family":"Rampinelli","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology \u2013 Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fausto","family":"Sessa","sequence":"additional","affiliation":[{"name":"Unit of Pathology, ASST Sette Laghi, University of Insubria, Varese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirley Y.","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Turri-Zanoni","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Ardighieri","sequence":"additional","affiliation":[{"name":"Department of Molecular and Translational Medicine, University of Brescia, ASST Spedali Civili, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"McKean","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matt","family":"Lechner","sequence":"additional","affiliation":[{"name":"UCL Cancer Institute, University College London and Head and Neck Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom"},{"name":"Division of Surgery and Interventional Science, University College London, and National Hospital Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom"},{"name":"UCL Cancer Institute, University College London and Head and Neck Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehab","family":"Hanna","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States"},{"name":"UCL Cancer Institute, University College London and 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