Validation of the "Rome" Classification for Squamous Cell Carcinoma of the Nasal Vestibule

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; sinonasal cancer; squamous cell carcinoma; staging.

Figure 1

Kaplan–Meier survival estimates stratified per stage. Rome classification for the entire cohort: (A) locoregional control (n = 147); (B) disease-specific survival (n = 149); (C) overall survival (n = 149); Rome classification for the cohort excluding N+ patients: (D) locoregional control (n = 138); (E) disease-specific survival (n = 140); (F) overall survival (n = 140); UICC nasal cavity and paranasal sinuses for the entire cohort: (G) locoregional control (n = 147); (H) disease-specific survival (n = 149); (I) overall survival (n = 149).