Material and methods
A retrospective case series was conducted in a regional tertiary centre
for management of head and neck malignancies. All patients undergoing TR
for a SCC of the nasal vestibule between September 2003 and February
2021 were included. Patients with a follow-up shorter than three months
were excluded. Patients undergoing TR for nasal malignancies other than
SCC were also excluded (as outlined in figure 1). This study was
registered with the local research and development department as a
quality improvement project (reference number 10343).
The methodology was in accordance
with the Process 2020 Guideline
(http://www.processguideline.com/).
Due to the absence of clear-cut recommendations or guidelines, the
regional multidisciplinary team proposed upfront surgery (partial or
total rhinectomy) whenever feasible. For clinically N0 (cN0) necks, the
multidisciplinary team generally recommended an elective neck dissection
for very advanced tumours only. Adjuvant radiotherapy was indicated for
positive or close margins or advanced T stage. Prophylactic irradiation
of the neck for N0 disease was not considered. Concurrent chemotherapy
was considered if tumour was locally advanced (T4) or in the presence of
nodal metastasis with extracapsular extension.
Patient charts were reviewed retrospectively to identify the following
information; gender, age, comorbidities, risk factors, tumour staging,
histological findings, type of surgery and reconstruction,
complications, adjuvant therapy and follow-up. The main endpoints were
Overall Survival (OS), Disease-Free Survival (DFS), Disease-Specific
Survival (DSS), and the prognostic factors for recurrence.