Validation of the “Rome” Classification for Squamous Cell Carcinoma of the Nasal Vestibule
by
, , , , , ,
Willem Frederik Julius Scheurleer
1,*
,
Mischa de Ridder
2,
Luca Tagliaferri
3,
Claudia Crescio
4,5,
Claudio Parrilla
6,
Gian Carlo Mattiucci
7,
Bruno Fionda
3,
Alberto Deganello
8,
Jacopo Galli
6,
Remco de Bree
1
,
Johannes A. Rijken
1 and
Francesco Bussu
4,5 1
Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
2
Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
3
Radiation Oncology Division, Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
4
Otolaryngology Division, Azienda Ospedaliero Universitaria Sassari, Viale S. Pietro 43, 07100 Sassari, Italy
5
Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale S. Pietro 43, 07100 Sassari, Italy
6
Otolaryngology Division, Department of Neurosciences, Sensory Organs and Thorax, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
7
Department of Radiation Oncology, Mater Olbia Hospital, SS 125 Orientale Sarda, 07026 Olbia, Italy
8
Department of Otolaryngology-Head and Neck Surgery, IRCCS Istituto Nazionale dei Tumori (INT), 20133 Milan, Italy
*
Author to whom correspondence should be addressed.
Cancers 2024, 16(1), 37; https://doi.org/10.3390/cancers16010037
Submission received: 14 November 2023
/
Revised: 14 December 2023
/
Accepted: 15 December 2023
/
Published: 20 December 2023
(This article belongs to the Special Issue Setting the Standards for Malignancies of the Nose Vestibule)
Simple Summary
Nasal vestibule cancer is considered to be a rare form of cancer. There are several different staging systems in place for categorizing these tumors, which can result in inconsistencies and unreliable data due to variations in registration. The “Rome” classification is the most recent addition. This study aimed to assess the effectiveness of this new staging system and to compare it to the UICC/AJCC system. One hundred and forty-nine patients with a squamous cell carcinoma of the nasal vestibule were included. There was a significant association between an increased disease stage as staged per the Rome classification and decreased survival. This association persisted when correcting for various covariates (i.e., age at the time of diagnosis, sex, the presence of lymph node metastases, and treatment modality) in multivariable analysis. The Rome classification appears to be capable of adequately categorizing and stratifying patients for different outcome measures. Nevertheless, additional research with a larger number of patients is required before any definitive conclusions can be drawn.
Abstract
Squamous cell carcinoma of the nasal vestibule is considered a rare malignancy that differs from other sinonasal malignancies in many respects. Four staging systems currently exist for this disease, the most recent addition being the “Rome” classification. This study assesses the use of this new classification and its prognostic value regarding various outcome measures. A retrospective multicenter cohort study of patients with a primary squamous cell carcinoma of the nasal vestibule who were treated in three tertiary head and neck oncology referral centers was conducted. A total of 149 patients were included. The median follow-up duration was 27 months. Five-year locoregional control (LRC), disease-specific survival (DSS), and overall survival (OS) were 81.6%, 90.1, and 62.5% respectively. A statistically significant association was observed between the Rome classification and all survival outcomes in both univariable and multivariable analyses. Moreover, it appeared to perform better than the Union for International Cancer Control TNM classification for tumors of the nasal cavity and paranasal sinuses. The new Rome classification can be used effectively and is associated with LRC, DSS, and OS. However, it requires further validation in a larger (prospective) study population.
Keywords:
nasal vestibule; squamous cell carcinoma; sinonasal cancer; staging
