Predictive factors for decreased baseline quality of life in patients with sinonasal malignancies

Cara M Fleseriu; Daniel M Beswick; Sabrina L Maoz; Peter H Hwang; Garret Choby; Edward C Kuan; Erik P Chan; Nithin D Adappa; Mathew Geltzeiler; Anne E Getz; Ian M Humphries; Christopher H Le; Waleed M Abuzeid; Eugene H Chang; Aria Jafari; Todd T Kingdom; Michael A Kohanski; Jivianne K Lee; Seyed A Nabavizadeh; Jayakar V Nayak; James N Palmer; Zara M Patel; Carlos D Pinheiro-Neto; Adam C Resnick; Timothy L Smith; Carl H Snyderman; Maie A St John; Jay Storm; Jeffrey D Suh; Marilene B Wang; Eric W Wang

doi:10.1002/alr.23261

Predictive factors for decreased baseline quality of life in patients with sinonasal malignancies

Int Forum Allergy Rhinol. 2024 Apr;14(4):775-785. doi: 10.1002/alr.23261. Epub 2023 Aug 30.

Authors

Cara M Fleseriu¹, Daniel M Beswick², Sabrina L Maoz², Peter H Hwang³, Garret Choby⁴, Edward C Kuan⁵, Erik P Chan³, Nithin D Adappa⁶, Mathew Geltzeiler⁷, Anne E Getz⁸, Ian M Humphries⁹, Christopher H Le¹⁰, Waleed M Abuzeid⁹, Eugene H Chang¹⁰, Aria Jafari⁹, Todd T Kingdom⁸, Michael A Kohanski⁶, Jivianne K Lee², Seyed A Nabavizadeh⁶, Jayakar V Nayak³, James N Palmer⁶, Zara M Patel³, Carlos D Pinheiro-Neto⁴, Adam C Resnick¹¹, Timothy L Smith⁷, Carl H Snyderman¹, Maie A St John², Jay Storm¹¹, Jeffrey D Suh², Marilene B Wang², Eric W Wang¹

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
² Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.
³ Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA.
⁴ Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
⁵ Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, California, USA.
⁶ Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁷ Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.
⁸ Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.
⁹ Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA.
¹⁰ Department of Otolaryngology-Head and Neck Surgery, University of Arizona, Tucson, Arizona, USA.
¹¹ Center for Data Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

PMID: 37646428
DOI: 10.1002/alr.23261

Abstract

Background: 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.

Keywords: SNOT‐22; nasopharyngeal carcinoma; paranasal sinuses; quality of life.

Publication types

Multicenter Study
Observational Study

MeSH terms

Chronic Disease
Endoscopy
Female
Humans
Male
Quality of Life
Rhinitis*
Skull Base
Skull Base Neoplasms*
Treatment Outcome

Abstract

Publication types

MeSH terms

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