TY - JOUR
T1 - Sinonasal Sarcomas Management
T2 - An International Consensus Statement
AU - Vinciguerra, Alessandro
AU - Caspani, Francesca
AU - Valentini, Marco
AU - Camarda, Anna Maria
AU - Provenzano, Salvatore
AU - Wang, Eric W.
AU - Meço, Cem
AU - Ferrari, Marco
AU - Surda, Pavol
AU - Harrabi, Semi
AU - Campos, Fernando Augusto Batista
AU - Broto, Javier Martin
AU - Guadagnolo, B. Ashleigh
AU - Navarria, Pierina
AU - Hosni, Ali
AU - Hindi, Nadia
AU - Italiano, Antoine
AU - Trifiletti, Daniel M.
AU - Kasper, Bernd
AU - Verillaud, Benjamin
AU - Schreiber, Alberto
AU - Castelnuovo, Paolo
AU - Nicolai, Piero
AU - Dallan, Iacopo
AU - Chacon, Matias
AU - Su, Shirley Y.
AU - Thariat, Juliette
AU - Valverde, Claudia
AU - Lechner, Matt
AU - Blay, Jean Yves
AU - Fiore, Maria Rosaria
AU - Eloy, Jean Anderson
AU - Brahmi, Mehdi
AU - Palmer, James N.
AU - Oliden, Victor Castro
AU - Greto, Daniela
AU - Lugowska, Iwona
AU - Tos, Angelo Paolo Dei
AU - van Zele, Thibaut
AU - Psaltis, Alkis J.
AU - Casali, Paolo Giovanni
AU - Dufresne, Armelle
AU - Sangalli, Claudia
AU - Georgalas, Christos
AU - Orlandi, Ester
AU - Wormald, Peter John
AU - Herman, Philippe
AU - Carrau, Ricardo
AU - Hanna, Ehab Y.
AU - Licitra, Lisa
AU - Turri-Zanoni, Mario
AU - Battaglia, Paolo
N1 - Publisher Copyright:
© 2025 The Author(s). International Forum of Allergy & Rhinology published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngic Allergy and American Rhinologic Society.
PY - 2026/1
Y1 - 2026/1
N2 - Introduction: Sinonasal sarcomas are exceedingly rare entities, constituting less than 7% of head and neck sarcomas. Their complex histology needs specialized treatment, which is often based on multimodal approaches including surgery, radiation therapy, and/or chemotherapy. This manuscript aims to gather expert opinions to establish common management principles for sinonasal sarcomas. Methods: This international consensus followed a modified Delphi method in seven steps, including statements definition by the core group, expert panel recruitment, and a two-round survey. Sixty-two statements on sinonasal sarcoma management were developed. Experts from multiple continents participated, and results were anonymized and analyzed between March and May 2025. Results: A total of 44 invited experts were recruited, 43.2% otorhinolaryngologists/head and neck surgeons, 31.8% medical oncologists, and 25% radiation oncologists. Participants varied in age and experience, representing Europe (70.5%), North America (18.2%), South America (6.8%), and Asia (4.5%). Among all histologies, biphenotypic sarcoma, chondrosarcoma, leiomyosarcoma, and myofibrosarcoma are principally treated with an upfront surgical management, differently from Ewing sarcoma and rhabdomyosarcoma in which chemotherapy, eventually associated with radiotherapy, is often chosen. In the remaining histologies (angiosarcoma, liposarcoma, malignant peripheral nerve sheath tumor [MPNST], osteosarcoma, and synovial sarcoma), a precise multimodal treatment is less standardized and needs to be discussed on a case-by-case basis. Conclusion: Sinonasal sarcomas require a histology-driven approach to determine upfront treatment, whether surgical, medical, or multimodal. Despite this structured strategy, prognosis remains highly variable across subtypes. Multidisciplinary evaluation and individualized management in referral centers are crucial to address the biological diversity and anatomical complexity of these rare malignancies.
AB - Introduction: Sinonasal sarcomas are exceedingly rare entities, constituting less than 7% of head and neck sarcomas. Their complex histology needs specialized treatment, which is often based on multimodal approaches including surgery, radiation therapy, and/or chemotherapy. This manuscript aims to gather expert opinions to establish common management principles for sinonasal sarcomas. Methods: This international consensus followed a modified Delphi method in seven steps, including statements definition by the core group, expert panel recruitment, and a two-round survey. Sixty-two statements on sinonasal sarcoma management were developed. Experts from multiple continents participated, and results were anonymized and analyzed between March and May 2025. Results: A total of 44 invited experts were recruited, 43.2% otorhinolaryngologists/head and neck surgeons, 31.8% medical oncologists, and 25% radiation oncologists. Participants varied in age and experience, representing Europe (70.5%), North America (18.2%), South America (6.8%), and Asia (4.5%). Among all histologies, biphenotypic sarcoma, chondrosarcoma, leiomyosarcoma, and myofibrosarcoma are principally treated with an upfront surgical management, differently from Ewing sarcoma and rhabdomyosarcoma in which chemotherapy, eventually associated with radiotherapy, is often chosen. In the remaining histologies (angiosarcoma, liposarcoma, malignant peripheral nerve sheath tumor [MPNST], osteosarcoma, and synovial sarcoma), a precise multimodal treatment is less standardized and needs to be discussed on a case-by-case basis. Conclusion: Sinonasal sarcomas require a histology-driven approach to determine upfront treatment, whether surgical, medical, or multimodal. Despite this structured strategy, prognosis remains highly variable across subtypes. Multidisciplinary evaluation and individualized management in referral centers are crucial to address the biological diversity and anatomical complexity of these rare malignancies.
KW - angiosarcoma
KW - biphenotypic sinonasal sarcoma
KW - chondrosarcoma
KW - Ewing sarcoma
KW - leiomyosarcoma
KW - malignant peripheral nerve sheath tumor
KW - osteosarcoma
KW - rhabdomyosarcoma
KW - sinonasal sarcomas
KW - synovial sarcoma
UR - https://www.scopus.com/pages/publications/105018189743
U2 - 10.1002/alr.70038
DO - 10.1002/alr.70038
M3 - Article
C2 - 41025537
AN - SCOPUS:105018189743
SN - 2042-6976
VL - 16
SP - 55
EP - 69
JO - International Forum of Allergy and Rhinology
JF - International Forum of Allergy and Rhinology
IS - 1
ER -