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  • 1
    Online Resource
    Online Resource
    Surgical approach is associated with complication rate in sinonasal malignancy: A multicenter study
    Wiley ; 2021
    In:  International Forum of Allergy & Rhinology Vol. 11, No. 12 ( 2021-12), p. 1617-1625
    Details
    In: International Forum of Allergy & Rhinology, Wiley, Vol. 11, No. 12 ( 2021-12), p. 1617-1625
    Abstract: Management of sinonasal malignancy (SNM) often includes surgical resection as part of the multimodality treatment. Treatment‐related surgical morbidity can occur, yet risk factors associated with complications in this population have not been sufficiently investigated. Methods Adult patients with histologically confirmed SNM whose primary treatment included surgical resection were prospectively enrolled into an observational, multi‐institutional cohort study from 2015 to 2020. Sociodemographic, disease, and treatment data were collected. Complications assessed included cerebrospinal fluid leak, orbital injury, intracranial injury, diplopia, meningitis, osteoradionecrosis, hospitalization for neutropenia, and subsequent chronic rhinosinusitis. The surgical approach was categorized as endoscopic resection (ER) or open/combined resection (O/CR). Associations between factors and complications were analyzed using Student's t test, Fisher's exact test, and logistic regression modeling. Results Overall, 142 patients met the inclusion criteria. Twenty‐three subjects had at least 1 complication (16.2%). On unadjusted analysis, adjuvant radiation therapy was associated with developing a complication (91.3% vs 65.5%, p = 0.013). Compared with the ER group (n = 98), the O/CR group (n = 44) had a greater percentage of higher T‐stage lesions ( p = 0.004) and more frequently received adjuvant radiation (84.1% vs 64.4%, p = 0.017) and chemotherapy (50.0% vs 30.6%, p = 0.038). Complication rates were similar between the ER and O/CR groups without controlling for other factors. Regression analysis that retained certain factors showed O/CR was associated with increased odds of experiencing a complication (odds ratio, 3.34; 95% confidence interval, 1.06‐11.19). Conclusions Prospective, multicenter evaluation of SNM treatment outcomes is feasible. Undergoing O/CR was associated with increased odds of developing a complication after accounting for radiation therapy. Further studies are warranted to build upon these findings.
    Type of Medium: Online Resource
    ISSN: 2042-6976 , 2042-6984
    URL: Issue
    URL: Article
    DOI: 10.1002/alr.v11.12
    DOI: 10.1002/alr.22833
    Language: English
    Publisher: Wiley
    Publication Date: 2021
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  • 2
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    Long‐term quality of life after treatment in sinonasal malignancy: A prospective, multicenter study
    Wiley ; 2023
    In:  International Forum of Allergy & Rhinology
    Details
    In: International Forum of Allergy & Rhinology, Wiley
    Abstract: Quality of life (QOL) for individuals with sinonasal malignancy (SNM) is significantly under‐studied, yet it is critical for counseling and may impact treatment. In this study we evaluated how patient, treatment, and disease factors impact sinonasal‐specific and generalized QOL using validated metrics in a large cohort over a 5‐year posttreatment time frame. Methods Patients with SNM who underwent definitive treatment with curative intent were enrolled in a prospective, multisite, longitudinal observational study. QOL was assessed using the 22‐item Sino‐Nasal Outcome Test (SNOT‐22) and University of Washington Quality of Life Questionnaire (UWQOL) instruments at pretreatment baseline and multiple follow‐ups through 5 years posttreatment. Multivariable modeling was used to determine demographic, disease, and treatment factors associated with disease‐specific and generalized physical and social/emotional function QOL. Results One hundred ninety‐four patients with SNM were analyzed. All QOL indices were impaired at pretreatment baseline and improved after treatment. SNOT‐22 scores improved 3 months and UWQOL scores improved 6 to 9 months posttreatment. Patients who underwent open compared with endoscopic tumor resection had worse generalized QOL ( p   〈  0.001), adjusted for factors including T stage. Pterygopalatine fossa (PPF) involvement was associated with worse QOL (SNOT‐22, p   〈  0.001; UWQOL Physical dimension, p  = 0.02). Adjuvant radiation was associated with worse disease‐specific QOL ( p  = 0.03). Neck dissection was associated with worse generalized physical function QOL ( p  = 0.01). Positive margins were associated with worse generalized social/emotional function QOL ( p  = 0.01). Conclusion Disease‐specific and generalized QOL is impaired at baseline in patients with SNM and improves after treatment. Endoscopic resection is associated with better QOL. PPF involvement, adjuvant radiation, neck dissection, and positive margins were associated with worse QOL posttreatment.
    Type of Medium: Online Resource
    ISSN: 2042-6976 , 2042-6984
    URL: Article
    DOI: 10.1002/alr.23171
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2604059-1
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  • 3
    Online Resource
    Online Resource
    Predictive factors for decreased baseline quality of life in patients with sinonasal malignancies
    Wiley ; 2023
    In:  International Forum of Allergy & Rhinology
    Details
    In: International Forum of Allergy & Rhinology, Wiley
    Abstract: The impact of sinonasal malignancies (SNMs) on quality of life (QOL) at presentation is poorly understood. The Sinonasal Outcome Test (SNOT‐22) and University of Washington Quality of Life (UWQOL) are validated QOL instruments with distinctive subdomains. This study aims to identify factors impacting pretreatment QOL in SNM patients to personalize multidisciplinary management and counseling. Methods Patients with previously untreated SNMs were prospectively enrolled (2015–2022) in a multicenter observational study. Baseline pretreatment QOL instruments (SNOT‐22, UWQOL) were obtained along with demographics, comorbidities, histopathology/staging, tumor involvement, and symptoms. Multivariable regression models identified factors associated with reduced baseline QOL. Results Among 204 patients, presenting baseline QOL was significantly reduced. Multivariable regression showed worse total SNOT‐22 QOL in patients with skull base erosion ( p  = 0.02). SNOT‐rhinologic QOL was worse in women ( p  = 0.009), patients with epistaxis ( p  = 0.036), and industrial exposure ( p  = 0.005). SNOT extranasal QOL was worse in patients with industrial exposure ( p  = 0.016); worse SNOT ear/facial QOL if perineural invasion (PNI) ( p  = 0.027). Squamous cell carcinoma pathology ( p  = 0.037), palate involvement ( p  = 0.012), and pain ( p  = 0.017) were associated with worse SNOT sleep QOL scores. SNOT psychological subdomain scores were significantly worse in patients with palate lesions ( p  = 0.022), skull base erosion ( p  = 0.025), and T1 staging ( p  = 0.023). Low QOL was more likely in the presence of PNI on UW health ( p  = 0.019) and orbital erosion on UW overall ( p  = 0.03). UW social QOL was worse if palatal involvement ( p  = 0.023) or PNI ( p  = 0.005). Conclusions Our findings demonstrate a negative impact on baseline QOL in patients with SNMs and suggest sex‐specific and symptom‐related lower QOL scores, with minimal histopathology association. Anatomical tumor involvement may be more reflective of QOL than T‐staging, as orbital and skull base erosion, PNI, and palate lesions are significantly associated with reduced baseline QOL.
    Type of Medium: Online Resource
    ISSN: 2042-6976 , 2042-6984
    URL: Article
    DOI: 10.1002/alr.23261
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2604059-1
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