Extranodal Extension as an Indicator for Sinonasal Squamous Cell Carcinoma Prognosis

Christopher C. Tseng, Jeff Gao, Gregory L. Barinsky, Christina H. Fang, Jordon G. Grube, Jean Anderson Eloy, Wayne Daniel Hsueh

Research output: Contribution to journalArticlepeer-review


Objective: Although extranodal extension (ENE) is a known indicator of poor prognosis for head and neck malignancies, its value as an indicator for sinonasal squamous cell carcinoma (SCC) has not been well characterized. This study seeks to assess the usefulness of ENE as a prognostic marker for sinonasal SCC. Study Design: Retrospective database review. Setting: National Cancer Database from 2010 to 2015. Methods: The National Cancer Database was queried from 2010 to 2015 for all patients with sinonasal SCC with available ENE status (n = 355). These cases were divided into those with pathologically confirmed ENE (n = 146) and those without ENE (n = 209). Univariate and multivariate analyses were used to examine survival differences and predictors of ENE status. Results: Most patients with ENE were ≥60 years old (61.7%), male (61.6%), and white (83.6%). Patients aged 60 to 69 and 80+ years were more likely to have ENE than those under 60 years (P <.05). Patients with ENE had worse 1-year overall survival than those without ENE (58.2% vs 70.8%, log-rank P =.008). After multivariate regression, however, there was no survival difference detected between ENE-positive and ENE-negative cases (hazard ratio, 1.14 [0.775-1.672], P =.508). Conclusion: ENE status did not have a significant effect on survival in patients with sinonasal SCC. Thus, ENE alone may not necessarily be a helpful indicator for sinonasal SCC prognosis.

Original languageEnglish (US)
Pages (from-to)438-445
Number of pages8
JournalOtolaryngology - Head and Neck Surgery (United States)
Issue number3
StatePublished - Sep 2021
Externally publishedYes


  • National Cancer Database
  • extranodal extension
  • head and neck cancer
  • prognostic factors
  • sinonasal malignancy
  • squamous cell carcinoma

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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