Primary surgical treatment of nasal vestibule cancer - therapeutic outcome and reconstructive strategies

Objective: The treatment strategy of squamous cell carcinoma of the nasal vestibule (SCCNV) is controversial. The objective of this study is to investigate the role of surgery, which is the preferred treatment option at our institution. Design: This was a monocentric prospective study of patients that were diagnosed with SCCNV between 2005 and 2013. Material and Methods: Twenty-six patients were included. Tumors were staged using the UICC (7th edition) TNM classification of nasal cavity cancer and the classification proposed by Wang. The primary treatment was surgery' in all patients. Survival data were statistically analyzed using the Kaplan-Meier method. The median follow-up time was 6 years. Results: Using the UICC classification, 9/26 tumors were staged as pT1 (35%), 7/26 as pT2 (27%), and 10/26 as pT4a (39%). Using the classification by Wang, 9/26 tumors were staged as pT1 (35%), 15/26 as pT2 (58%), and 2/26 as pT3 (8%). Reconstruction was performed using an implant-retained prosthesis in 50% of patients and by plastic surgery in the remaining 50%. Only 2/26 patients (8%) needed adjuvant radiation therapy. The five-year recurrence-free survival (RFS) was 86.7%, disease-specific survival was 96.2% and overall survival was 91.8% after five years. Conclusion: Surgery in SCCNV gives an excellent prognosis and minimized the need for radiotherapy.