Abstract：
BACKGROUND: Squamous cell carcinoma of the nasal cavity (NCSCC) is a rare, challenging malignancy. Surgical resection of this tumor can cause significant facial deformity, and indications for adjuvant or organ preservation therapies are not well-described.
OBJECTIVE: To examine the impact of treatment regimen on survival outcomes in NCSCC and to compare surgical to non-surgical based therapies.
METHODS: The National Cancer Database was queried for NCSCC from 2004 to 2014. Patient demographics, tumor characteristics, and treatment regimen were compared for the entire cohort. Multivariable Cox proportional hazards regression was performed for statistical analysis of treatment regimen and surgical margins on overall survival (OS) for early and late-stage disease.
RESULTS: A total of 1883 NCSCC patients were identified. The OS for the cohort was 83 months, and median age at diagnosis was 65 years. NCSCC patients who underwent surgery followed by adjuvant radiation therapy (RT) had a better OS compared to definitive RT (HR: 0.58, P < .001). In early stage NCSCC (T1/T2, N0), there was no significant difference in OS between patients treated with surgery only or surgery with adjuvant RT compared to definitive RT. In advanced stage NCSCC, surgery with adjuvant RT had a better OS compared to definitive chemoradiation. Having positive margins was shown to predict a worse OS when compared to negative margins in surgical patients despite adjuvant RT or chemoradiation.
CONCLUSIONS: NCSCC appears to be best treated with surgery followed by adjuvant RT in advanced-stage disease whereas in early-stage disease, surgery does not improve OS compared to definitive RT.
OBJECTIVE: To examine the impact of treatment regimen on survival outcomes in NCSCC and to compare surgical to non-surgical based therapies.
METHODS: The National Cancer Database was queried for NCSCC from 2004 to 2014. Patient demographics, tumor characteristics, and treatment regimen were compared for the entire cohort. Multivariable Cox proportional hazards regression was performed for statistical analysis of treatment regimen and surgical margins on overall survival (OS) for early and late-stage disease.
RESULTS: A total of 1883 NCSCC patients were identified. The OS for the cohort was 83 months, and median age at diagnosis was 65 years. NCSCC patients who underwent surgery followed by adjuvant radiation therapy (RT) had a better OS compared to definitive RT (HR: 0.58, P < .001). In early stage NCSCC (T1/T2, N0), there was no significant difference in OS between patients treated with surgery only or surgery with adjuvant RT compared to definitive RT. In advanced stage NCSCC, surgery with adjuvant RT had a better OS compared to definitive chemoradiation. Having positive margins was shown to predict a worse OS when compared to negative margins in surgical patients despite adjuvant RT or chemoradiation.
CONCLUSIONS: NCSCC appears to be best treated with surgery followed by adjuvant RT in advanced-stage disease whereas in early-stage disease, surgery does not improve OS compared to definitive RT.
摘要：
背景：鼻腔鳞状细胞癌（NCSCC）是一种罕见的，具有挑战性的恶性肿瘤。手术切除这种肿瘤会导致明显的面部畸形，以及辅助或器官保存疗法的适应症没有得到很好的描述。
目的：研究治疗方案对NCSCC生存结局的影响，并比较手术和非手术治疗。
方法：国家癌症数据库从2004年到2014年被查询为NCSCC。患者人口统计学，肿瘤特征，对整个队列的治疗方案进行了比较。多变量Cox比例风险回归用于统计分析早期和晚期疾病的治疗方案和手术切缘对总生存期（OS）的影响。
结果：共确认了1883例NCSCC患者。该队列的OS为83个月，诊断时的中位年龄为65岁.NCSCC患者接受手术后进行辅助放疗（RT），其OS优于确定性放疗（HR：0.58，P<.001）。在早期NCSCC（T1/T2，N0），与确定性RT相比,单纯手术或辅助RT手术患者的OS无显著差异.在高级NCSCC中，与确定性放化疗相比,辅助RT手术具有更好的OS.尽管进行了辅助RT或放化疗，但与手术患者的阴性切缘相比，阳性切缘可预测OS较差。
结论：在晚期疾病中，NCSCC似乎最好采用手术治疗，然后进行辅助放疗，而在早期疾病中，与确定性RT相比，手术并不能改善OS。
目的：研究治疗方案对NCSCC生存结局的影响，并比较手术和非手术治疗。
方法：国家癌症数据库从2004年到2014年被查询为NCSCC。患者人口统计学，肿瘤特征，对整个队列的治疗方案进行了比较。多变量Cox比例风险回归用于统计分析早期和晚期疾病的治疗方案和手术切缘对总生存期（OS）的影响。
结果：共确认了1883例NCSCC患者。该队列的OS为83个月，诊断时的中位年龄为65岁.NCSCC患者接受手术后进行辅助放疗（RT），其OS优于确定性放疗（HR：0.58，P<.001）。在早期NCSCC（T1/T2，N0），与确定性RT相比,单纯手术或辅助RT手术患者的OS无显著差异.在高级NCSCC中，与确定性放化疗相比,辅助RT手术具有更好的OS.尽管进行了辅助RT或放化疗，但与手术患者的阴性切缘相比，阳性切缘可预测OS较差。
结论：在晚期疾病中，NCSCC似乎最好采用手术治疗，然后进行辅助放疗，而在早期疾病中，与确定性RT相比，手术并不能改善OS。
