Prognostic factors and survival outcomes of multimodal treatment in sinonasal neuroendocrine tumors in a population based SEER analysis
- 1Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna
- 2Medical Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
Abstract
Purpose Sinonasal neuroendocrine carcinomas (SNECs) are rare and aggressive malignancies with heterogeneous histopathology and limited evidence guiding optimal treatment. This study aims to characterize clinicopathological features, treatment patterns, and prognostic factors using a large population-based database. Methods We queried the SEER database (2000–2022) for histologically confirmed SNECs. Kaplan-Meier analysis was used to estimate overall survival (OS) and disease-specific survival (DSS). Univariate and multivariate Cox models were employed to identify independent prognostic factors. Results A total of 389 cases were identified, mostly male (58.4%) with a median age of 60 years and nasal cavity as primary site (48.1%). Neuroendocrine carcinoma not otherwise specified (50.1%) was the most frequent, followed by small cell (35.0%) and large cell carcinoma (10.5%). Nearly 38% of patients presented with metastatic disease. Surgery, radiotherapy, and chemotherapy were administered in 54.1%, 66.9%, and 69.9% of cases, respectively. Kaplan-Meier analysis showed improved OS and DSS in patients with localized/locally advanced stage, lower tumor grade, nasal cavity primary site, and those treated with surgery, radiotherapy (particularly adjuvant), or chemotherapy (all p < 0.05). In multivariate models, primary sites outside the nasal cavity were independently associated with worse OS and DSS, while surgery and radiotherapy remained the only treatment modality significantly associated with improved outcomes. Conclusion In this large population-based study, SNECs were characterized by advanced-stage presentation and use of multimodal therapy. Radiotherapy was independently associated with improved OS/DSS in multivariable models, supporting aggressive local treatment in SNECs and underscoring the need for therapeutic strategies tailored to disease stage and tumor location.
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BibTeX
@article{carosi2026prognostic,
title = {{Prognostic factors and survival outcomes of multimodal treatment in sinonasal neuroendocrine tumors in a population based SEER analysis}},
author = {Francesca Carosi and Laura Fabbri and Giuseppe Lamberti and Elisa Andrini and Elisabetta Nobili and Daria Maria Filippini and Davide Campana},
journal = {Discover Oncology},
year = {2026},
month = jul,
doi = {10.1007/s12672-026-05441-y},
url = {https://doi.org/10.1007/s12672-026-05441-y},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prognostic factors and survival outcomes of multimodal treatment in sinonasal neuroendocrine tumors in a population based SEER analysis
AU - Francesca Carosi
AU - Laura Fabbri
AU - Giuseppe Lamberti
AU - Elisa Andrini
AU - Elisabetta Nobili
AU - Daria Maria Filippini
AU - Davide Campana
PY - 2026
DA - 2026/07/01
JO - Discover Oncology
DO - 10.1007/s12672-026-05441-y
UR - https://doi.org/10.1007/s12672-026-05441-y
AB - Purpose Sinonasal neuroendocrine carcinomas (SNECs) are rare and aggressive malignancies with heterogeneous histopathology and limited evidence guiding optimal treatment. This study aims to characterize clinicopathological features, treatment patterns, and prognostic factors using a large population-based database. Methods We queried the SEER database (2000–2022) for histologically confirmed SNECs. Kaplan-Meier analysis was used to estimate overall survival (OS) and disease-specific survival (DSS). Univariate and multivariate Cox models were employed to identify independent prognostic factors. Results A total of 389 cases were identified, mostly male (58.4%) with a median age of 60 years and nasal cavity as primary site (48.1%). Neuroendocrine carcinoma not otherwise specified (50.1%) was the most frequent, followed by small cell (35.0%) and large cell carcinoma (10.5%). Nearly 38% of patients presented with metastatic disease. Surgery, radiotherapy, and chemotherapy were administered in 54.1%, 66.9%, and 69.9% of cases, respectively. Kaplan-Meier analysis showed improved OS and DSS in patients with localized/locally advanced stage, lower tumor grade, nasal cavity primary site, and those treated with surgery, radiotherapy (particularly adjuvant), or chemotherapy (all p < 0.05). In multivariate models, primary sites outside the nasal cavity were independently associated with worse OS and DSS, while surgery and radiotherapy remained the only treatment modality significantly associated with improved outcomes. Conclusion In this large population-based study, SNECs were characterized by advanced-stage presentation and use of multimodal therapy. Radiotherapy was independently associated with improved OS/DSS in multivariable models, supporting aggressive local treatment in SNECs and underscoring the need for therapeutic strategies tailored to disease stage and tumor location.
SN - 2730-6011
ER -