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

SNOT-22 nasopharyngeal carcinoma paranasal sinuses quality of life

Journal

International forum of allergy & rhinology
ISSN: 2042-6984
Titre abrégé: Int Forum Allergy Rhinol
Pays: United States
ID NLM: 101550261

Informations de publication

Date de publication:
30 Aug 2023
Historique:
revised: 18 07 2023
received: 07 04 2023
accepted: 22 08 2023
medline: 30 8 2023
pubmed: 30 8 2023
entrez: 30 8 2023
Statut: aheadofprint

Résumé

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. 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. 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). 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.

Sections du résumé

BACKGROUND 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 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 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 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.

Identifiants

pubmed: 37646428
doi: 10.1002/alr.23261
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Natlie A. Cole-Reagins Foundation
Organisme : International Society of Inflammation and Allergy of the Nose

Informations de copyright

© 2023 ARS-AAOA, LLC.

Références

Chow VJ, Tsetsos N, Poutoglidis A, Georgalas C. Quality of life in sinonasal tumors: an up-to-date review. Curr Opin Otolaryngol Head Neck Surg. 2022;30(1):46-57.
International WHO. WHOQOL: Measuring Quality of Life. Accessed January 26th, 2022. https://www.who.int/tools/whoqol Published 2021
Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol. 2009;34(5):447-454.
Sarris CE, Little AS, Kshettry VR, et al. Assessment of the validity of the Sinonasal outcomes Test-22 in pituitary surgery: a multicenter prospective trial. Laryngoscope. 2021;131(11):E2757-E2763.
Rogers SN, Lowe D, Yueh B. The physical function and social-emotional function subscales of the University of Washington Quality of Life Questionnaire. Arch Otolaryngol Head Neck Surg. 2010;136(4):352-357.
Beswick DM, Holsinger FC, Kaplan MJ, et al. Design and rationale of a prospective, multi-institutional registry for patients with sinonasal malignancy. Laryngoscope. 2016;126(9):1977-1980.
Chowdhury NI, Mace JC, Bodner TE, et al. Investigating the minimal clinically important difference for SNOT-22 symptom domains in surgically managed chronic rhinosinusitis. Int Forum Allergy Rhinol. 2017;7(12):1149-1155.
Phillips KM, Hoehle LP, Caradonna DS, Gray ST, Sedaghat AR. Minimal clinically important difference for the 22-item Sinonasal Outcome Test in medically managed patients with chronic rhinosinusitis. Clin Otolaryngol. 2018;43(5):1328-1334.
Binenbaum Y, Amit M, Billan S, Cohen JT, Gil Z. Minimal clinically important differences in quality of life scores of oral cavity and oropharynx cancer patients. Ann Surg Oncol. 2014;21(8):2773-2781.
Glicksman JT, Parasher AK, Brooks SG, et al. Sinonasal quality of life after endoscopic resection of malignant sinonasal and skull base tumors. Laryngoscope. 2018;128(4):789-793.
Philips R, Agarwal A, Chitguppi C, et al. Quality of life outcomes in patients with sinonasal malignancy after definitive treatment. Laryngoscope. 2021;131(7):E2212-E2221.
Tyler MA, Mohamed ASR, Smith JB, et al. Long-term quality of life after definitive treatment of sinonasal and nasopharyngeal malignancies. Laryngoscope. 2020;130(1):86-93.
Wang EW, Zanation AM, Gardner PA, et al. ICAR: endoscopic skull-base surgery. Int Forum Allergy Rhinol. 2019;9(S3):S145-S365.
Gillett S, Hopkins C, Slack R, Browne JP. A pilot study of the SNOT 22 score in adults with no sinonasal disease. Clin Otolaryngol. 2009;34(5):467-469.
Lange B, Thilsing T, Baelum J, Kjeldsen AD. The Sinonasal Outcome Test 22 score in persons without chronic rhinosinusitis. Clin Otolaryngol. 2016;41(2):127-130.
Farhood Z, Schlosser RJ, Pearse ME, Storck KA, Nguyen SA, Soler ZM. Twenty-two-item Sino-Nasal Outcome Test in a control population: a cross-sectional study and systematic review. Int Forum Allergy Rhinol. 2016;6(3):271-277.
Stephens RF, Noel CW, Su J, et al. Mapping the University of Washington Quality of life questionnaire onto EQ-5D and HUI-3 indices in patients with head and neck cancer. Head Neck. 2020;42(3):513-521.
Beswick DM, Hwang PH, Adappa ND, et al. Surgical approach is associated with complication rate in sinonasal malignancy: a multicenter study. Int Forum Allergy Rhinol. 2021;11(12):1617-1625.
Lal D, Golisch KB, Elwell ZA, Divekar RD, Rank MA, Chang Y-H. Gender-specific analysis of outcomes from endoscopic sinus surgery for chronic rhinosinusitis. Int Forum Allergy Rhinol. 2016;6(9):896-905.
Binazzi A, Ferrante P, Marinaccio A. Occupational exposure and sinonasal cancer: a systematic review and meta-analysis. BMC Cancer. 2015;15:49.
Phillips KM, Sedaghat AR. Depression and anxiety: considerations for interpretation of the SNOT-22 (22-Item Sinonasal Outcome Test). Otolaryngol Head Neck Surg. 2022;166(5):985-992.
Bracigliano A, Tatangelo F, Perri F, et al. Malignant sinonasal tumors: update on histological and clinical management. Curr Oncol (Toronto). 2021;28(4):2420-2438.
Turner JH, Reh DD. Incidence and survival in patients with sinonasal cancer: a historical analysis of population-based data. Head Neck. 2012;34(6):877-885.

Auteurs

Cara M Fleseriu (CM)

Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Daniel M Beswick (DM)

Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.

Sabrina L Maoz (SL)

Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.

Peter H Hwang (PH)

Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA.

Garret Choby (G)

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Edward C Kuan (EC)

Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, California, USA.

Erik P Chan (EP)

Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA.

Nithin D Adappa (ND)

Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Mathew Geltzeiler (M)

Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.

Anne E Getz (AE)

Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.

Ian M Humphries (IM)

Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA.

Christopher H Le (CH)

Department of Otolaryngology-Head and Neck Surgery, University of Arizona, Tucson, Arizona, USA.

Waleed M Abuzeid (WM)

Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA.

Eugene H Chang (EH)

Department of Otolaryngology-Head and Neck Surgery, University of Arizona, Tucson, Arizona, USA.

Aria Jafari (A)

Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA.

Todd T Kingdom (TT)

Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.

Michael A Kohanski (MA)

Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Jivianne K Lee (JK)

Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.

Seyed A Nabavizadeh (SA)

Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Jayakar V Nayak (JV)

Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA.

James N Palmer (JN)

Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Zara M Patel (ZM)

Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA.

Carlos D Pinheiro-Neto (CD)

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Adam C Resnick (AC)

Center for Data Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Timothy L Smith (TL)

Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.

Carl H Snyderman (CH)

Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Maie A St John (MA)

Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.

Jay Storm (J)

Center for Data Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Jeffrey D Suh (JD)

Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.

Marilene B Wang (MB)

Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.

Eric W Wang (EW)

Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Classifications MeSH