• Jacky T Yeung, David M Caminer, Isabella M Young, Michael E Sughrue, and Charles Teo.
• Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, Australia.
• World Neurosurg. 2021 Jun 1; 150: e102-e107.

BackgroundThe role of surgery is not well defined in locally advanced sinonasal cancers with intracranial involvement after all medical options have been exhausted. We hypothesize that patients whose tumors are deemed unresectable and referred to palliative care may benefit from radical salvage surgery.MethodsWe performed a single-center retrospective review of patients with malignant, locally advanced (stage T4b) sinonasal cancers with intracranial involvement from 2000 to 2020, inclusive. Data were collected on the patient demographics, details of chemotherapy, radiation, histology, perioperative complications, surgical approaches, and survival. We compared the survival outcomes of patients with different duration of disease before presentation.ResultsWe identified 17 patients who had undergone salvage surgical resection of treatment-recalcitrant, locally advanced sinonasal tumors. Almost all patients had undergone prior surgery, radiotherapy, and chemotherapy. Perioperative complications occurred in 6 of 17 patients with 1 death. Patients with clinically less aggressive disease had significantly longer progression-free and overall survival compared with the more aggressive group.ConclusionsSalvage surgery for locally advanced sinonasal cancers with intracranial invasion that is recalcitrant to all other therapies should be considered for patients who otherwise have no other treatment options.Crown Copyright © 2021. Published by Elsevier Inc. All rights reserved.

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