Comorbidity burden and nonclinical factors associated with sinonasal cancer all‐cause mortality

Desai, Premal B.; Bukatko, Aleksandr R.; Simpson, Matthew C.; Boakye, Eric Adjei; Greenberg, Jason W.; Ward, Greg; Walker, Rebecca; Antisdel, Jastin L.; Osazuwa-Peters, Nosayaba

doi:10.1002/lary.28223

Cited by 5 publications

(7 citation statements)

References 52 publications

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“…Without these data to guide management, developing a unifying approach to this group of diseases has proven difficult and improvements in survival have remained elusive. [34][35][36][37] Consistent with prior work, 33,[38][39][40] we found that higher grade and T stage and increasing age and Charlson-Deyo comorbidity score were associated with worse survival. Several other factors also influence survival among patients with anterior skull base malignancies, 31,33,[38][39][40] but were not specifically explored in this study.…”

Section: Other Factors Influencing Survivalsupporting

confidence: 88%

Prognosis of Distant Metastatic Sites in Anterior Skull Base Malignancies

Kraft

Carey

Prasad

et al. 2021

J Neurol Surg B Skull Base

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Objective This study aimed to provide information regarding the prognosis of patients presenting with metastatic anterior skull base malignancies based upon histology and site of distant metastasis (DM). Patients and Methods The National Cancer Database was queried for patients with anterior skull base malignant neoplasms with DM. Outcomes Prognosis was compared between site of DM and tumor histologies. A multivariable Cox proportional hazards model was used to identify prognostic factors for overall survival (OS). Results A total of 481 patients were identified. Lung was the most common site of DM (24.9%), followed by bone (22.2%), liver (5.6%), and brain (2.5%). Lung was the most common site for squamous cell carcinoma (SCCa) (28.3%), melanoma (37.7%), and adenoid cystic carcinoma (ACC; 31.4%). The median survival for patients presenting with metastatic disease regardless of tumor histology was 9.0 months (95% confidence interval [CI]: 8.2–10.3), and patients with metastasis to the liver had the best median survival at 15.5 months (95% CI: 10.5–25.6). The median survivals for the most common histologies, SCCa, melanoma, and ACC were 8.2 months (95% CI: 5.5–10.2), 10.5 months (95% CI: 8.7–14.1), and 15.0 months (95% CI: 11.1–61.1), respectively. Multivariable analysis demonstrated worse overall survival (OS) for older patients, higher Charlson-Deyo comorbidity scores, and tumors with higher grade and T stage. Compared with metastasis to bone, lung metastasis had better OS on multivariable analysis (hazard ratio [HR]: 0.70, 95% CI: 0.51–97). Adenoid cystic carcinoma had improved OS compared with SCCa (HR: 0.62, 95% CI: 0.39–99). Conclusion Tumor histology, metastatic sites, and several disease factors affected prognosis in anterior skull base malignancies with DM.

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Section: Other Factors Influencing Survivalsupporting

confidence: 88%

Prognosis of Distant Metastatic Sites in Anterior Skull Base Malignancies

Kraft

Carey

Prasad

et al. 2021

J Neurol Surg B Skull Base

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“…[1][2][3][4] For patients with paranasal sinus cancer, race is associated with worse outcomes, including increased rates of nodal metastasis and worse disease-specific and overall survival. [5][6][7] The mechanism of this relationship is uncertain, although some studies have suggested that worse outcomes for certain demographic groups occur secondary to delayed presentation as well as suboptimal delivery of care. [8][9][10] Primary paranasal sinus cancers are rare, comprising only about 2% to 3% of head and neck cancer, with squamous cell carcinoma being the most common histologic diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…For head and neck cancer, age‐adjusted incidence is increased in some races, such as African Americans, and 5‐year survival rates tend to be lower overall despite similarities in care 1–4 . For patients with paranasal sinus cancer, race is associated with worse outcomes, including increased rates of nodal metastasis and worse disease‐specific and overall survival 5–7 . The mechanism of this relationship is uncertain, although some studies have suggested that worse outcomes for certain demographic groups occur secondary to delayed presentation as well as suboptimal delivery of care 8–10 …”

Section: Introductionmentioning

confidence: 99%

Racial and ethnic disparities in paranasal sinus malignancies

Sharma

Schlosser

Beswick

et al. 2021

Int Forum Allergy Rhinol

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Background: Racial and ethnic disparities in cancer outcomes have been demonstrated for several different malignancies. In this study we aimed to quantify disease-specific survival (DSS) and the 5-year conditional disease-specific survival (CDSS, the change in life expectancy with increasing survivorship) for paranasal sinus cancer by race and ethnicity. Methods: Patients with sinus cancer between 1973 and 2015 were extracted from the Surveillance, Epidemiology, End Results (SEER) registry. Kaplan-Meier analysis for DSS was stratified by race and ethnicity. Cox regression models of DSS were generated controlling for stage, age, race, and ethnicity. CDSS was calculated using Cox models. Logistic regression was conducted to identify risk factors for younger age at diagnosis, late-stage at diagnosis, and likelihood of receiving surgical intervention when recommended. Results:The analysis included a total of 5202 patients. DSS was significantly different when stratified by race (p < 0.01). Compared with White patients, Black patients (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.13-1.45; p < 0.001) and American Indian/Alaskan Natives (HR, 1.94; 95% CI, 1.37-2.74, p < 0.001) exhibited increased mortality when controlling for other factors.Black patients had worse CDSS for regional and distant staged cancer compared with other races; American Indian/Alaskan Native patients had worse CDSS for cancers of all stages. Hispanic patients were more likely to present with advanced disease (odds ratio [OR], 1.47; 95% CI, 1.07-2.07; p = 0.020). American Indian/Alaskan Native patients were less likely than White patients to receive surgical intervention when recommended (OR, 0.42; 95% CI, 0.21-0.04; p = 0.024). Nonwhite patients were more likely to be diagnosed at a younger age.Variations in racial and ethnic disparities were observed over time. Conclusion: Race and ethnicity significantly impact paranasal sinus cancer outcome metrics. Disparities in outcomes are likely multifactorial.

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“…41,46 This is similar to the incidence peak of sinonasal malignancies, but differs from that of benign sinonasal lesions, which may occur at an earlier age. 56,57 Previous publications suggest that this tumor entity is found predominantly in females, and the presence of progesterone and estrogen in leiomyomas may contribute to this tumor's bias toward the female sex. 28,47 However, our study suggests that the incidence of sinonasal leiomyomas is evenly distributed among the sexes, with a slight male predominance (52.4%).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis, Treatment and Follow-Up of Sinonasal Leiomyomas: A Systematic Review

Runge

Randhawa

Mayo-Patiño

et al. 2023

Am J Rhinol�Allergy

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Background Leiomyomas are benign smooth muscle tumors that are rarely diagnosed in the nasal cavity and paranasal sinuses. Objective This systematic review summarizes the histopathologic and clinical tumor characteristics, surgical management, and follow-up of sinonasal leiomyomas. Methods A systematic review of the literature on sinonasal leiomyoma was performed by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies that met the inclusion criteria were assessed for level of evidence. Patient demographics, clinical and pathological tumor characteristics, primary intervention, and results of follow-up were evaluated. Results Forty studies including 84 patients with sinonasal leiomyoma were identified. The tumor was most often located in the nasal cavity (47/84, 56%) originating from the inferior turbinate (32/84, 38%). Patients mostly presented with symptoms originating from an intranasal mass, including recurrent epistaxis (41/84, 49%), nasal obstruction (43/84, 51.2%), and localized facial or head pain (25/84, 29.8%). Surgery was performed in all cases. An endoscopic approach was most frequently chosen. Recurrence occurred only twice (2.4%). Morbidity was noted in 2 cases (2.4%) following postoperative bleeding and 1 (1.2%) case following a CSF leak. Conclusion Sinonasal leiomyomas are neoplasms of the smooth muscle manifesting clinically with recurrent epistaxis and nasal obstruction. Management goal is total resection with clear margins to avoid local recurrence.

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Comorbidity burden and nonclinical factors associated with sinonasal cancer all‐cause mortality

Cited by 5 publications

References 52 publications

Prognosis of Distant Metastatic Sites in Anterior Skull Base Malignancies

Prognosis of Distant Metastatic Sites in Anterior Skull Base Malignancies

Racial and ethnic disparities in paranasal sinus malignancies

Diagnosis, Treatment and Follow-Up of Sinonasal Leiomyomas: A Systematic Review

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