Clinical Features and Prognostic Insights in Sinonasal Sarcomas: A 76-Case Single-Institution Experience

Abstract

Objective

This study analyzed the clinical characteristics, treatment outcomes, and prognostic factors of sinonasal sarcomas through a single-institution experience involving 76 cases over 27 years.

Methods

A retrospective review was conducted on 76 patients diagnosed with sinonasal sarcoma at a tertiary medical center from 1995 to 2022. Data collected included demographic information, tumor characteristics, and treatment modalities. Survival outcomes were assessed using Kaplan–Meier analysis, and prognostic factors were identified through univariate and multivariate Cox proportional hazards models.

Results

The cohort included 45 males and 31 females, with a mean age of 42.6 years. The most common presenting symptom was nasal obstruction (22%). Rhabdomyosarcoma was the most prevalent subtype, accounting for 27.6% of cases. The 5- and 10-year overall survival (OS) rates were 62% and 56%, while the disease-free survival (DFS) rates were 51% and 41%. Survival outcomes were significantly worse in patients aged ≥ 61 years (p = 0.030), with a smoking history (p = 0.005), or with neurovascular extension (p = 0.015). In the univariate analysis, smoking history increased the mortality risk by 2.95-fold (p = 0.008) and neurovascular involvement by 2.87-fold (p = 0.020). Multivariate Cox analysis confirmed smoking history as an independent predictor of mortality (HR = 2.38, 95% CI: 1.05–5.40, p = 0.038).

Conclusions

The results showed that advanced age, smoking history, and neurovascular involvement were key contributors to reduced survival, with identified as a significant independent predictors of higher mortality risk. These findings offer critical insight into the therapeutic management of this rare malignancy.

Level of Evidence

4