Endonasal endoscopic surgery for sinonasal squamous cell carcinoma from an oncological perspective

Akihiro Homma; Yuji Nakamaru; Valerie J Lund; Ehab Y Hanna; Luiz Paulo Kowalski; Ronaldo Nunes Toledo; Antti A Mäkitie; Juan Pablo Rodrigo; Alessandra Rinaldo; Carl H Snyderman; Alfio Ferlito

doi:10.1016/j.anl.2020.11.018

Endonasal endoscopic surgery for sinonasal squamous cell carcinoma from an oncological perspective

Auris Nasus Larynx. 2021 Feb;48(1):41-49. doi: 10.1016/j.anl.2020.11.018. Epub 2020 Dec 4.

Authors

Affiliations

¹ Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15 West 7, Sapporo 060-8638, Japan. Electronic address: [email protected].
² Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15 West 7, Sapporo 060-8638, Japan.
³ Royal National Throat Nose and Ear Hospital, UCLH Foundation Trust, London, United Kingdom.
⁴ Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
⁵ Division of Head and Neck Surgery, University of São Paulo Medical School and Department of Head and Neck Surgery and Otolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Head and Neck Surgery and Otolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil.
⁶ Department of Head and Neck Surgery and Otolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil.
⁷ Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland.
⁸ Department of Otolaryngology, Hospital Universitario Central de Asturias, ISPA, IUOPA, University of Oviedo, CIBERONC, Oviedo, Spain.
⁹ University of Udine School of Medicine, Udine, Italy.
¹⁰ Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
¹¹ International Head and Neck Scientific Group, Padua, Italy.

PMID: 33280972
DOI: 10.1016/j.anl.2020.11.018

Abstract

Endonasal endoscopic surgery (EES) has been applied to the management of sinonasal (SN) tumors based on recent advances in endoscopic surgical techniques and technologies over the past three decades. EES has been mainly indicated for benign tumors and less aggressive malignant tumors. Notwithstanding this, EES has been gradually adopted for squamous cell carcinoma (SCC), which is the most common histology among SN malignancies. However, an analysis of the outcomes of EES for patients with SCC is difficult because most articles included SCC a wide range of different tumor histologies. Therefore, we herein review and clarify the current status of EES focusing on SCC from an oncological perspective. The oncologic outcomes and the ability to achieve a histologically complete resection are similar between endoscopic and open approaches in highly selected patients with SN-SCC. Surgical complications associated with EES are likely similar for SN-SCC compared to other sinonasal malignancies. The indications for a minimally invasive approach such as EES in the management of patients with SN-SCC should be stricter than those for less aggressive malignant tumors because of the aggressive nature of SCC. Also, it is important to achieve negative surgical margins with EES in patients with SCC. We believe that the indications for EES for SN-SCC are widening due to advances in diagnostic imaging, and endoscopic surgical techniques and technologies. However, while expanding the indications for EES for SN-SCC we must carefully confirm that the outcomes support this strategy.

Keywords: Endonasal endoscopic surgery; Nasal cavity; Paranasal sinus; Sinonasal; Squamous cell carcinoma.

Publication types

Review

MeSH terms

Carcinoma, Squamous Cell / surgery*
Combined Modality Therapy
Humans
Natural Orifice Endoscopic Surgery* / adverse effects
Paranasal Sinus Neoplasms / surgery*