Prognostic indicators in carcinoma of the nasal vestibule

Objectives: Squamous cell carcinoma of the nasal vestibule is rare variant of skin cancer. The TNM classification for skin cancer has been used, whereas, Wang has devised an independent staging system, which he stated was more accurate. The purpose of this study was to analyse the prognostic indicators for survival in a patients with nasal vestibule cancer from the Princess Margaret Hospital, Toronto. Design: A retrospective review of case notes from the Princess Margaret Hospital archives was performed. Setting: The Princess Margaret Hospital/Ontario Cancer Institute is the tertiary regional Head and Neck Oncology Centre for ON, Canada. Participants: All patients with nasal vestibule cancer (ICD10 C300) were included. Main outcome measures: Univariate and multivariate analyses were performed and Kaplan-Meier survival curves constructed. Results: Eighty-four patients were identified. The mean age was 67, there was a male preponderance of 2 : 1. Primary radical radiation was used in 77% of patients. Age (P = 0.02), N stage (P = 0.0001) and Wang classification (P = 0.0001) were associated with prediction of overall survival using multivariate analysis. Grade, depth of invasion and N stage were associated with disease-free survival outcome. A 5-year overall survival rate of 58% and disease-free survival of 52% was seen. Conclusion: Nasal vestibule cancer behaves in a more aggressive manner than any other skin cancers affecting the head and neck. The Wangs' classification appears to be a better prognostic indicator for overall survival then the TNM classification for skin cancer.