Long-term quality of life after treatment in sinonasal malignancy: A prospective, multicenter study.

TitleLong-term quality of life after treatment in sinonasal malignancy: A prospective, multicenter study.
Publication TypeJournal Article
Year of Publication2023
AuthorsMaoz SL, Wang EW, Hwang PH, Choby G, Kuan EC, Fleseriu CM, Chan EP, Adappa ND, Geltzeiler M, Getz AE, Humphreys IM, Le CH, Abuzeid WM, Chang EH, Jafari A, Kingdom TT, Kohanski MA, Lee JK, Lazor JW, Nabavizadeh A, Nayak JV, Palmer JN, Patel ZM, Pinheiro-Neto CD, Resnick AC, Smith TL, Snyderman CH, St John MA, Storm PB, Suh JD, Wang MB, Sim MS, Beswick DM
JournalInt Forum Allergy Rhinol
Date Published2023 Apr 21
ISSN2042-6984
Abstract

BACKGROUND: 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.

DOI10.1002/alr.23171
Alternate JournalInt Forum Allergy Rhinol
PubMed ID37082883
Grant List / / Natlie A. Cole-Reagins Foundation /
/ / International Society of Inflammation and Allergy of the Nose /
Faculty Reference: 
Christopher Le, MD, FACS