Thirty-two patients with squamous cell carcinoma of the anterior nasal cavi
ty were identified at two university hospitals. A retrospective review was
conducted to identify clinical presentation, initial therapy, recurrence ra
tes, and factors affecting survival. Treatment included surgery (n = 15), r
adiation therapy (n = 9), or combination therapy (n = 8). The primary lesio
ns involved either the septum, vestibule, columella, anterior floor, or a c
ombination of these subsites. The primary tumor involved a single nasal sub
site in 22 patients and multiple nasal subsites in 10 patients. All patient
s had de novo squamous lesions, and all tumors were staged NO at initial di
agnosis. Six patients received prophylactic neck irradiation, and none unde
rwent elective neck dissection. Overall, 18 (56%) patients had recurrent di
sease after primary therapy (5 local and 13 regional), The 5-year disease-f
ree survival was 42%, and the 5-year overall survival was 50%. None of the
patients receiving prophylactic neck irradiation had a regional recurrence.
Involvement of 2 or more nasal subsites significantly decreased survival (
P < 0.05). Squamous cell carcinoma of the anterior nasal cavity is an aggre
ssive disease, and combined therapy initially with strong consideration for
prophylactic radiation to the facial and cervical lymphatics is advocated.