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

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 facto...

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Published in:	International forum of allergy & rhinology Vol. 14; no. 4; pp. 775 - 785
Main Authors:	Fleseriu, Cara M., Beswick, Daniel M., Maoz, Sabrina L., Hwang, Peter H., Choby, Garret, Kuan, Edward C., Chan, Erik P., Adappa, Nithin D., Geltzeiler, Mathew, Getz, Anne E., Humphries, Ian M., Le, Christopher H., Abuzeid, Waleed M., Chang, Eugene H., Jafari, Aria, Kingdom, Todd T., Kohanski, Michael A., Lee, Jivianne K., Nabavizadeh, Seyed A., Nayak, Jayakar V., Palmer, James N., Patel, Zara M., Pinheiro‐Neto, Carlos D., Resnick, Adam C., Smith, Timothy L., Snyderman, Carl H., St. John, Maie A., Storm, Jay, Suh, Jeffrey D., Wang, Marilene B., Wang, Eric W.
Format:	Journal Article
Language:	English
Published:	United States Wiley Subscription Services, Inc 01-04-2024
Subjects:	Chronic Disease Comorbidity Endoscopy Female Head & neck cancer Histopathology Humans Male Malignancy nasopharyngeal carcinoma Palate Paranasal sinus paranasal sinuses Quality of Life Regression analysis Rhinitis Skull Skull Base Skull Base Neoplasms SNOT‐22 Squamous cell carcinoma Throat cancer Treatment Outcome Tumors nasopharyngeal carcinoma paranasal sinuses quality of life SNOT‐22
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	2042-6976 2042-6984
DOI:	10.1002/alr.23261