Dissecting heterogeneity in epithelial sinonasal cancer

Epithelial, non-glandular sinonasal cancers (SNCs) is a rare disease, with a global dismal prognosis. There are no recognized targeted treatments and the knowledge of molecular mechanisms involved in the resistance to available therapies is limited. Dissecting the heterogeneity of paranasal sinus cancersSNCs and providing valuable information on the biology of the malignancy is eagerly needed to improve therapeutic approaches. We selected a retrospective cohort of 47 SNCs including: i) non keratinizing squamous cell cancer (NKSCC, n=21); ii) sinonasal neuroendocrine cancer (SNEC, n=13); iii) sinonasal undifferentiated cancer (SNUC, n=13). Main tumor subsite was the ethmoid sinus (62%), followed by nasal cavity (26%), maxillary sinus and other subsites (6% each). Locally advanced stages were the most represented (stage III and IV 91%), mainly due to advanced T stage (T4a 19%; T4b 53%). Treatment modality was multimodal, comprising surgery followed by adjuvant radiation (with or without concomitant chemotherapy) in 70% of the cases and curative chemoradiation, with or without induction chemotherapy, in 30% of the patients.