Elective neck dissection for T3/T4 cN0 sinonasal squamous cell carcinoma

Abstract Background In locally advanced sinonasal squamous cell carcinoma (SNSCC), management of the clinically node‐negative (cN0) neck is variable and elective neck dissection (END) remains controversial. Methods Patients with surgically treated T3/T4 cN0 M0 SNSCC were identified using the NCDB. Overall survival (OS) was assessed by Cox proportional hazard analysis in propensity score‐matched cohorts. Factors associated with END were evaluated with logistic regression. Results Two hundred twenty patients underwent END (19.6%). END did not correlated with OS in propensity score‐matched cohorts (HR 0.971, 95% CI 0.677‐1.392), a maxillary sinus tumor subgroup (HR 1.089, 95% CI 0.742‐1.599), or by radiation status [radiation: (HR 0.802, 95% CI 0.584‐1.102); no radiation: (HR 0.852, 95% CI 0.502‐1.445)]. The occult metastasis rate in the END cohort was 12.7%. Conclusion END did not significantly improve OS in this study. Further information on disease‐free survival is necessary to determine its role in advanced‐stage SNSCC.